MOUNTAIN WEST DERM - BLACKHART PLLC
NPI 1013557933
Dermatology in Spokane Valley, WA

Q: What is Mountain West Derm - Blackhart PLLC's NPI number?

The NPI number for Mountain West Derm - Blackhart PLLC is 1013557933. It was assigned to this organization in the NPPES registry on January 8, 2020. The provider is doing business as Advanced Dermatology & Skin Surgery.

Q: What is Mountain West Derm - Blackhart PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Active since January 08, 2020CLIA 13D2032958 · Certificate of Compliance

1807 N HUTCHINSON RD, SPOKANE VALLEY, WA 99212(509) 456-7414(509) 624-0763 Get Directions Write a Review

NPPES record last updated: January 8, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mountain West Derm - Blackhart Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOUNTAIN WEST DERM - BLACKHART PLLC (NPI 1013557933), doing business as Advanced Dermatology & Skin Surgery, is a healthcare organization registered as a dermatology in Spokane Valley, Washington and active in the NPI registry since January 2020. The organization holds a CLIA Certificate of Compliance certificate valid through March 25, 2027, maintains 2 additional practice locations, and lists Bret S Blackhart, Owner, as its authorized official.

NPPES Registry Identity

NPI1013557933

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NameMOUNTAIN WEST DERM - BLACKHART PLLC

Location Address1807 N HUTCHINSON RDSpokane Valley, WA 99212-2444

Mailing Address1807 N Hutchinson RdSpokane Valley, WA 99212-2444 · (509) 456-7414 · Fax (509) 624-0763

Phone(509) 456-7414

Fax(509) 624-0763

Organization SubpartNo

Authorized OfficialBret S BlackhartOwner · (775) 336-3624

Enumeration DateJanuary 8, 2020

✔ NPI 1013557933 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Also ListedDermatology · DermatopathologyTaxonomy 207ND0900X

Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X

1807 N HUTCHINSON RD, Spokane Valley, WA 99212

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Other Names 1

Doing Business AsAdvanced Dermatology & Skin Surgery

Secondary Practice Locations 2

Location 11700 W Riverstone DrCoeur D Alene, ID 83814-5683 · Phone (208) 770-2822 · Fax (208) 770-2911

Location 25905 N Mayfair St Ste 200Spokane, WA 99208-1127 · Phone (509) 456-7414 · Fax (509) 624-0764

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Premera Blue Cross Blue Shield of Alaska.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 13D2032958

Mountain West Derm Blackhart PLLC Dba Advanced Dermatology & Skin Surgery · Coeur D'alene, ID

Active · expires Mar 25, 2027

CLIA Number13D2032958

Laboratory TypePhysician Office

Certificate Effective DateMarch 26, 2025

Certificate Expiration DateMarch 25, 2027

Laboratory DirectorDr. Chad Sukut

Laboratory Phone(509) 456-7414

Laboratory LocationMountain West Derm Blackhart PLLC Dba Advanced Dermatology & Skin Surgery1700 W Riverstone Dr, Coeur D'alene, ID 83814

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMES KEITH PARKER MD

Dermatology