Black Stone Health – Pain Clinic/Center, NPI 1649776394

Black Stone Health is a healthcare provider. based in Bonney lake, Washington. specializing in Pain Clinic/Center. The NPI Number for Black Stone Health is 1649776394

Main info

Organization
Name
Black Stone Health
NPI
1649776394
Phone
(253) 983-9390
Address
21509 State Route 410 E Ste 1B
Authorized Official
JOSH LEDER ADMINISTRATOR
Enumeration Date
2 April 2018
Last Update Date
9 February 2026
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness90
Years active:8State licenses:0Digital endpoints

Provider Addresses for Black Stone Health

  • 21509 State Route 410 E Ste 1B

    Bonney Lake, WA 983914104

    Phone: (253) 983-9390

    Type: Location

  • 9715 N Nevada St

    Spokane, WA 992183412

    Phone: (801) 903-1122

    Type: Location

  • 9220 Ridgetop Blvd NW Ste 120

    Silverdale, WA 983838583

    Phone: (360) 415-9110

    Fax: (360) 479-0265

    Type: Location

  • 388 State St Ste 420

    Salem, OR 973013581

    Phone: (541) 368-5986

    Type: Location

  • 21509 State Route 410 E Ste 1A

    Bonney Lake, WA 983914104

    Phone: (253) 891-2160

    Type: Location

  • 2314 NW Kings Blvd Ste B

    Corvallis, OR 973303925

    Phone: (541) 368-5986

    Type: Location

  • 11306 Bridgeport Way SW Ste D

    Lakewood, WA 984993037

    Phone: (253) 983-9390

    Type: Location

  • 4404 80th St NE

    Marysville, WA 982703427

    Phone: (360) 839-6778

    Type: Location

  • 1849 NW Kearney St Ste 301

    Portland, OR 972091453

    Phone: (503) 477-5205

    Type: Location

  • 2296 NW Kings Blvd Ste 101

    Corvallis, OR 973303871

    Phone: (541) 368-5986

    Type: Location

  • 5122 Olympic Dr Ste A-204

    Gig Harbor, WA 983351767

    Phone: (360) 415-9110

    Type: Location

  • 4029 Northwest Ave Ste 303

    Bellingham, WA 982269077

    Phone: (360) 526-8685

    Fax: (360) 733-8320

    Type: Location

  • 2298 NW Kings Blvd

    Corvallis, OR 973303923

    Phone: (541) 368-5986

    Type: Location

  • 9220 Ridgetop Blvd NW Ste 200

    Silverdale, WA 983838556

    Phone: (360) 415-9110

    Type: Location

  • 6101 Summitview Ave Ste 200

    Yakima, WA 989083028

    Phone: (360) 839-6778

    Type: Location

  • 120 14th Ave SE Ste D

    Puyallup, WA 983723718

    Phone: (253) 200-2144

    Type: Location

  • 17615 SE 272nd St Ste 102

    Covington, WA 980424957

    Phone: (253) 983-9390

    Type: Location

  • 6808 220th St SW Ste 201

    Mountlake Terrace, WA 980432187

    Phone: (360) 839-6778

    Type: Location

  • 16410 Smokey Point Blvd Ste 210

    Arlington, WA 982238415

    Phone: (360) 200-4388

    Type: Location

  • 7200 S 180th St Ste 102

    Tukwila, WA 981882988

    Phone: (253) 983-9390

    Type: Location

  • 340 E George Hopper Rd Ste 1

    Burlington, WA 982333153

    Phone: (360) 419-6868

    Type: Location

  • Northwest Avenue, Columbia, Bellingham, Whatcom County, Washington, 98225-2409, United States

    BELLINGHAM, WA 982269077

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-07-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-09-30 (616 days ago).

Enrollment records

3

Earliest due date

2024-09-30

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20180517001248OClinic/Group PracticeWA2024-09-30
O20220701000687OMulti-Specialty - PhysicianWA2026-01-31
O20220725002506OClinic/Group PracticeORTBD

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98391)

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Reviews

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Frequently asked questions

How do payers reference Black Stone Health?
For Black Stone Health, use NPI 1649776394 as the unique 10-digit identifier.
Is Black Stone Health shown as active in public data?
Registry records indicate Black Stone Health maintains an active NPI.
What kind of doctor is Black Stone Health?
Black Stone Health is associated with Pain Clinic/Center in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with Black Stone Health?
Directory geography for Black Stone Health centers on Bonney Lake, Washington.
What does 23 location(s) imply?
23 practice locations appear in the available data.

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