Organization
KORNERSTONE KIDS PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG PENNER (FOUNDER)
(360) 354-1115
Entity
Organization
Contact information
Practice address
400 SEQUOIA DR, SUITE 120, BELLINGHAM, WA 98226-7133
(360) 354-1115
Mailing address
8862 BENDER RD, SUITE 202, LYNDEN, WA 98264-8800
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
02/24/2016
Last updated
03/22/2016
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