Provider Demographics
NPI:1336407956
Name:CAPSTONE HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:CAPSTONE HEALTH SERVICES INC.
Other - Org Name:CAPSTONE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DPT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNETT
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:PENNER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, OCS, GCS
Authorized Official - Phone:360-255-7876
Mailing Address - Street 1:8862 BENDER RD.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LYNDEN
Mailing Address - State:WA
Mailing Address - Zip Code:98264
Mailing Address - Country:US
Mailing Address - Phone:360-255-7876
Mailing Address - Fax:360-354-0321
Practice Address - Street 1:8862 BENDER RD.
Practice Address - Street 2:SUITE 101
Practice Address - City:LYNDEN
Practice Address - State:WA
Practice Address - Zip Code:98264-9323
Practice Address - Country:US
Practice Address - Phone:360-354-1115
Practice Address - Fax:360-354-0321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-02
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00007467225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty