Provider Demographics
NPI:1598473472
Name:CORNERSTONE CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:CORNERSTONE CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:OH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-545-5644
Mailing Address - Street 1:PO BOX 99264
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98496-0264
Mailing Address - Country:US
Mailing Address - Phone:425-471-4083
Mailing Address - Fax:425-577-6509
Practice Address - Street 1:18904 HIGHWAY 99 STE F
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5219
Practice Address - Country:US
Practice Address - Phone:425-471-4083
Practice Address - Fax:425-577-6509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center