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Blue Mountain Family Health Pllc

Family Medicine Physician in Clarkston, WA · enumerated 2006 · authorized official Kevin Black, Administrator.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1679649248

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Registry record

Entity type Organization (Type 2)
Legal business name Blue Mountain Family Health Pllc
Other name <Unavail>
Practice address 1268 Bridge St, Clarkston, WA, 99403
Phone (509) 751-5500
Fax (509) 751-1059
Enumeration date Nov 27, 2006
Last updated in NPPES May 21, 2024

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians · License MD00045393 (WA) Primary

Authorized official

Name Kevin Black
Title Administrator
Phone (509) 751-5500

Other identifiers

Identifier Type State Issuer
7130354 Medicaid WA -
807278700 Medicaid ID -
80745000 Medicaid ID -
8439333 Medicaid WA -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is Blue Mountain Family Health Pllc located?
The practice location on file with NPPES is in Clarkston, WA.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2024-05-21. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-05-21.