Blossom Behavioral Health LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

BLOSSOM BEHAVIORAL HEALTH LLC

Practice address

930 N Mullan Rd Ste 1
Spokane Valley, WA 99206-4004

Phone

(509) 694-3135

Fax

(855) 308-6054

NPI assigned

May 17, 2021

Last updated

Feb 24, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Prince Eti

Title

Manager

Phone

(713) 992-2200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

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.

• Udoka Deborah Eti, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Spokane Valley, WA
  • NPI 1093166142
  Medicare reassignment NPD

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771891200000",
    "number": "1932773629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 N MULLAN RD STE 1",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992064004",
            "telephone_number": "509-694-3135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 N MULLAN RD STE 1",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992064004",
            "telephone_number": "509-694-3135",
            "fax_number": "855-308-6054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-17",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A",
        "authorized_official_last_name": "ETI",
        "authorized_official_first_name": "PRINCE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "713-992-2200"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chloe Blindauer
• Cory Jayce Bliss
• Maury Nelson Blitman, MD
• Jonell Marie Block, AUD
• David A Blomgren, P.A.
• Kate Elizabeth Bluestone, PMHNP-BC
• Natalie Bodey
• Gabrielle Boecker
• Heidi Ann Boehl, LMP
• Josann Eleanor Boever, RDH

• Psychiatric/Mental Health Nurse Practitioner in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.