Provider Demographics
NPI:1669768974
Name:CORNERSTONE FAMILY HEALTH CLINIC
Entity type:Organization
Organization Name:CORNERSTONE FAMILY HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATUROPATHIC DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MONWAI
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:425-821-1800
Mailing Address - Street 1:13115 121ST WAY NE
Mailing Address - Street 2:STE C
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034
Mailing Address - Country:US
Mailing Address - Phone:425-821-1800
Mailing Address - Fax:425-821-1818
Practice Address - Street 1:13115 121ST WAY NE
Practice Address - Street 2:SUITE C
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3051
Practice Address - Country:US
Practice Address - Phone:425-821-1800
Practice Address - Fax:425-821-1818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60201231207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty