Organization Active NPI

Cornerstone Medical Services Foundation

Doing business as Cornerstone Medical Clinic

  • Community Health Clinic/Center
  • Federal Way, WA
National Provider Identifier
1063855690
Registry record updated Apr 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
CORNERSTONE MEDICAL SERVICES FOUNDATION
Doing business as
Cornerstone Medical Clinic
Practice address
200 S 333Rd St
Ste. 140
Federal Way, WA 98003-7359
Phone
(253) 252-2095
NPI assigned
Apr 13, 2013
Last updated
Apr 13, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jai Jun Byeon, M.D.
Title
Chief Medical Officer
Phone
(360) 689-6268

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X NU
Family Medicine Physician 207Q00000X NU
Clinic/Center 261Q00000X NU
Community Health Clinic/Center 261QC1500X NU Primary

Addresses

Primary practice location

200 S 333Rd St
Ste. 140
Federal Way, WA 98003-7359

Mailing address

200 S 333Rd St
Ste. 140
Federal Way, WA 98003-7359
Phone (253) 252-2095

Other names 1

  • Cornerstone Medical Clinic Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365811200000",
    "number": "1063855690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S 333RD ST",
            "address_2": "STE. 140",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980037359",
            "telephone_number": "253-252-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S 333RD ST",
            "address_2": "STE. 140",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980037359",
            "telephone_number": "253-252-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE MEDICAL SERVICES FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-13",
        "last_updated": "2013-04-13",
        "status": "A",
        "authorized_official_last_name": "BYEON",
        "authorized_official_first_name": "JAI",
        "authorized_official_middle_name": "JUN",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "360-689-6268",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.