MEDICARE: CORNERSTONE FAMILY PHYSICIANS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	78740	OTHER	WA	L & I

General Provider Information

NPI Number	:	1700830213
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORNERSTONE FAMILY PHYSICIANS

Provider Business Mailing Address
First Line	:	5920 100TH ST SW
Second Line	:	SUITE 26
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-2751
Country	:	US
Telephone Number	:	253-588-0756
Fax Number	:	253-581-3787

Provider Business Practice Location Address
First Line	:	5920 100TH ST SW
Second Line	:	SUITE 26
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-2751
Country	:	US
Telephone Number	:	253-588-0756
Fax Number	:	253-581-3787

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. BRANDI M LYNCH
Credential	:
Telephone Number	:	253-588-0756

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	08/22/2020

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Directions to “CORNERSTONE FAMILY PHYSICIANS ” Practice Location

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