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BLUE MOUNTAIN FAMILY HEALTH
NPI 1679649248
Family Medicine in Clarkston, WA

Active since November 27, 2006CLIA 50D1045822 · Waiver
1268 BRIDGE ST, CLARKSTON, WA 99403(509) 751-5500(509) 751-1059 Get Directions Write a Review

NPPES record last updated: May 21, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Blue Mountain Family Health NPPES

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

BLUE MOUNTAIN FAMILY HEALTH (NPI 1679649248) is a healthcare organization registered as a family medicine in Clarkston, Washington and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Kevin James Black, Administrator, as its authorized official.

NPPES Registry Identity

NPI1679649248
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBLUE MOUNTAIN FAMILY HEALTH PLLC
Location Address1268 BRIDGE STClarkston, WA 99403-2219
Mailing Address1268 Bridge StClarkston, WA 99403-2219 · (509) 751-5500 · Fax (509) 751-1059
Phone(509) 751-5500
Fax(509) 751-1059
Organization SubpartNo
Authorized OfficialKevin James BlackAdministrator · (509) 751-5500
Enumeration DateNovember 27, 2006
Last NPPES UpdateMay 21, 2024
NPPES CertifiedMay 21, 2024
✔ NPI 1679649248 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WA · MD00045393
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1268 BRIDGE ST, Clarkston, WA 99403
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Other Names 1

Doing Business AsBlue Mountain Family Health

Other Identifiers 4

Medicaid7130354WA
Medicaid807278700ID
Medicaid80745000ID
Medicaid8439333WA

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 SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include 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 Waiver 50D1045822

Blue Mountain Family Health · Clarkston, WA
Active · expires Apr 4, 2028
CLIA Number50D1045822
Laboratory TypePhysician Office
Certificate Effective DateSeptember 23, 2005
Certificate Expiration DateApril 4, 2028
Laboratory DirectorElizabeth Black
Laboratory Phone(509) 751-5500
Laboratory LocationBlue Mountain Family Health1268 Bridge St, Clarkston, WA 99403
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

TODD M CARPENTER NP
Nurse Practitioner (Family)
1268 BRIDGE ST
CLARKSTON, WA 99403
Asotin County (509) 758-9524
CARPENTER HEALTH PLLC
Nurse Practitioner (Family)
1268 BRIDGE ST
CLARKSTON, WA 99403
Asotin County (509) 758-9524
ELIZABETH LEFFT BLACK MD
Family Medicine
1268 BRIDGE ST
CLARKSTON, WA 99403
Asotin County (509) 751-5500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blue Mountain Family Health PLLC's NPI number?

The NPI number for Blue Mountain Family Health PLLC is 1679649248. It was assigned to this organization in the NPPES registry on November 27, 2006. The provider is doing business as Blue Mountain Family Health.

Where is Blue Mountain Family Health PLLC located?

Blue Mountain Family Health PLLC is located at 1268 Bridge St, Clarkston, WA 99403. The listed phone number is (509) 751-5500.

What is Blue Mountain Family Health PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Blue Mountain Family Health PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D1045822) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Blue Mountain Family Health PLLC accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Blue Mountain Family Health PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Blue Mountain Family Health PLLC was last updated on May 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.