MOUNTAIN WEST DERM - BLACKHART PLLC (NPI# 1619517539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619517539 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN WEST DERM - BLACKHART PLLC |
| Practice Address |
1807 N Hutchinson Rd Spokane Valley WA 99212-2444 |
| Practice Telephone | 5094567414 |
| Practice Fax Number | 5096240764 |
| Mailing Telephone | 5094567414 |
| Mailing Fax Number | 5096240764 |
| Enumeration Date | 2020-01-08 |
| Last Update Date | 2020-01-08 |
| Authorized Official Name | BRET S BLACKHART (OWNER) |
| Authorized Official Telephone | 7753363624 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Advanced Dermatology & Skin Surgery | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1700 W Riverstone Dr, Coeur D Alene, ID 838145683 | 2087702822 | 2087702911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013557933 | Mountain West Derm - Blackhart Pllc | Dermatology | 1807 N Hutchinson Rd, Spokane Valley, WA 99212-2444 | 2020-01-08 |
| 1124670088 | Mountain West Derm - Blackhart Pllc | Dermatology | 3841 Piper St Ste T4-020, Anchorage, AK 99508-4673 | 2019-07-11 |
| 1447764741 | Mountain West Derm - Blackhart Pllc | Dermatology | 2747 Ne Conners Ave, Bend, OR 97701-8738 | 2017-11-22 |
| 1740633015 | Mountain West Derm - Blackhart Pllc | Dermatology | 3950 Gs Richards Blvd, Carson City, NV 89703-8457 | 2016-07-21 |
| Street Address |
1807 N HUTCHINSON RD |
| City | SPOKANE VALLEY |
| State | WA |
| Zip Code | 99212-2444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184699365 | Joel K Sears | Dermatology | 1807 N Hutchinson Rd, Spokane Valley, WA 99212-2444 | 2006-02-21 |
| 1013557933 | Mountain West Derm - Blackhart Pllc | Dermatology | 1807 N Hutchinson Rd, Spokane Valley, WA 99212-2444 | 2020-01-08 |
| 1477853760 | Thomas M Ryan, Md | Dermatology | 1807 N Hutchinson Rd, Spokane Valley, WA 99212-2444 | 2010-11-02 |
| 1710213558 | Kathleen R Lejameyer | Nurse Practitioner | 1807 N Hutchinson Rd, Spokane Valley, WA 99212-2444 | 2009-10-29 |
| 1467673061 | Chadd Sukut | Dermatology | 1807 N Hutchinson Rd, Spokane Valley, WA 99212-2444 | 2007-05-01 |
| 1154408631 | Elizabeth Joan Jacobsen | Physician Assistant | 1807 N Hutchinson Rd, Spokane Valley, WA 99212-2444 | 2006-11-01 |
| 1215023007 | Andrea Mead Dominey | Dermatology | 1807 N Hutchinson Rd, Spokane Valley, WA 99212-2444 | 2006-10-05 |
| 1689636649 | Jeanne M Ellern | Physician Assistant | 1807 N Hutchinson Rd, Spokane Valley, WA 99212-2444 | 2006-04-05 |
| 1972579845 | Advanced Dermatology and Skin Surgery Pllc | Clinical Medical Laboratory | 1807 N Hutchinson Rd, Spokane Valley, WA 99212-2444 | 2006-02-28 |
| 1881660751 | Advanced Dermatology and Skin Surgery, Pllc | Dermatology | 1807 N Hutchinson Rd, Spokane Valley, WA 99212-2444 | 2006-02-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750889580 | Melissa Lerai Lunsford | Massage Therapist | 1212 N Argonne Rd, Spokane Valley, WA 99212 | 2018-01-26 |
| 1225558539 | Paul James Hammerschmidt | Licensed Practical Nurse | 5600 E. 8th Avenue, Spokane Valley, WA 99212 | 2017-06-27 |
| 1497009302 | Ray A Schoessler | Pharmacist | 9009 E Trent Ave, Spokane, WA 99212 | 2012-10-30 |
| 1215205224 | Wchs Inc | Counselor | 4305 East Trent Avenue, Spokane, WA 99212 | 2011-12-05 |
| 1609159466 | Andrey V Altukhov | Specialist | 906 S. Park Rd, Spokane Valley, WA 99212 | 2011-09-27 |
| 1215189808 | Providence Health & Services - Wa | Home Health | 1000 N Argonne Rd, Spokane Valley, WA 99212 | 2008-10-15 |
| 1568674414 | Colleen Kirsten Monroe | Pharmacist | 5601 E Sprague, Spokane, WA 99212 | 2007-05-04 |
| 1205968534 | Jeremiah Michael Stevens | Naturopath | 1510 N Argonne Rd Ste G, Spokane Valley, WA 99212 | 2007-03-12 |
| 1104957547 | Lyudmila Larkin | Specialist | 8120 E. Vista Lane, Spokane, WA 99212 | 2007-03-08 |
| 1972613511 | Costco Wholesale Corporation | Pharmacy | 5601 E Sprague Ave, Spokane Valley, WA 99212 | 2006-08-30 |
| Find all providers in zip 99212 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609345727 | Liberty Asc | Clinic/Center | 507 N Sullivan Suite 120, Spokane Valley, WA 99037 | 2018-11-19 |
| 1902864879 | Spokane Surgery Center Ltd Ps | Clinic/Center | 1120 N Pines Road, Spokane Valley, WA 99206 | 2006-05-02 |
| 1548252968 | Foot and Ankle Clinic of Spokane Inc | Clinic/Center | 205 N University Rd Ste 4, Spokane Valley, WA 99206-5094 | 2005-08-22 |
| 1881065076 | Spokane Oral Surgery Asc | Clinic/Center | 12109 E Broadway Ave Ste C, Spokane Valley, WA 99206-6133 | 2015-10-13 |
| 1902228455 | Providence Health & Services Washington | Clinic/Center | 16528 Desmet Ct, Spokane Valley, WA 99216-3522 | 2014-01-16 |
| 1750521720 | Spokane Valley Ear Nose & Throat Ps | Clinic/Center | 1424 N. Mcdonald Rd, Suite 102, Spokane Valley, WA 99216 | 2009-03-03 |
| 1023253515 | Rockwood Valley Surgery Center | Clinic/Center | 1414 N Houk Rd, Suite 204, Spokane Valley, WA 99216-1097 | 2008-12-11 |
| 1467637116 | Inland Northwest Surgery Center Pllc | Clinic/Center | 526 N Mullan Rd, Ste. A, Spokane Valley, WA 99206-2408 | 2007-12-31 |
| 1235195132 | Valley Outpatient Surgery Center Lp | Clinic/Center | 1414 N Houk Rd, #204, Spokane Valley, WA 99216-1097 | 2006-04-21 |
| 1710952882 | Advanced Dermatology and Skin Surgery, Pllc | Clinic/Center | 1807 N Hutchinson Rd, Spokane Valley, WA 99212-2444 | 2006-02-21 |
| Find all providers in SPOKANE VALLEY | ||||
| City | SPOKANE VALLEY |
| Zip Code | 99212 |
Please comment or provide details below to improve the information on MOUNTAIN WEST DERM - BLACKHART PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.