Organization Active NPI

Snoqualmie Valley Clinic, PLLC

  • Family Medicine Physician
  • Issaquah, WA
National Provider Identifier
1457492936
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SNOQUALMIE VALLEY CLINIC, PLLC
Practice address
450 NW Gilman Blvd Ste 203
Issaquah, WA 98027-2483
Phone
(425) 888-2299
Fax
(425) 888-1204
NPI assigned
Feb 9, 2007
Last updated
Jan 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Sheri Moklebust
Title
Clinic Manager
Phone
(425) 888-2299

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X WA Primary

Addresses

Primary practice location

450 NW Gilman Blvd Ste 203
Issaquah, WA 98027-2483

Mailing address

PO Box 2013
Snoqualmie, WA 98065-2013
Phone (425) 888-2299

Other identifiers 1

IdentifierTypeStateIssuer
7020753MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040318000148 WA Part B Supplier - Clinic/Group Practice 1355231820 Receives reassigned benefits from 3 practitioners
Practice locations: Issaquah, WA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D0630978Snoqualmie Valley Clinic450 NW Gilman Blvd. Suite 204, Issaquah, WA 98027Provider-performed microscopyApr 4, 2028

National Provider Directory

National Provider Directory

Locations

450 NW Gilman Blvd
Ste 203
Issaquah, WA 98027
Phone (425) 454-3938

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768867200000",
    "number": "1457492936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2013",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980652013",
            "telephone_number": "425-888-2299",
            "fax_number": "425-888-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 NW GILMAN BLVD STE 203",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272483",
            "telephone_number": "425-888-2299",
            "fax_number": "425-888-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNOQUALMIE VALLEY CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A",
        "authorized_official_last_name": "MOKLEBUST",
        "authorized_official_first_name": "SHERI",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "425-888-2299",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7020753",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.