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Organization
BLUE MOUNTAIN HEALTH COOPERATIVE
Active
Organization
BLUE MOUNTAIN HEALTH COOPERATIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAYNA BRINTON LICSW (DIRECTOR)
(509) 840-4618
Entity
Organization
Contact information
Practice address
2330 EASTGATE ST STE 105, WALLA WALLA, WA 99362-1559
(509) 973-5788
Mailing address
2580 CHISHOLM CT, WALLA WALLA, WA 99362-9266
(509) 840-4618
(509) 769-5221
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2168971
—
WA
Enumeration date
10/22/2020
Last updated
07/23/2021
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