Provider Demographics
NPI:1275716748
Name:NORTHPOINTE FAMILY MEDICINE PLLC
Entity Type:Organization
Organization Name:NORTHPOINTE FAMILY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:COLLETTE
Authorized Official - Middle Name:ANTOINETTE
Authorized Official - Last Name:BLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-466-1271
Mailing Address - Street 1:9631 N NEVADA ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1133
Mailing Address - Country:US
Mailing Address - Phone:509-466-1271
Mailing Address - Fax:
Practice Address - Street 1:9631 N NEVADA ST
Practice Address - Street 2:SUITE 304
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1133
Practice Address - Country:US
Practice Address - Phone:509-466-1271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0200956OtherLABOR & INDUSTRIES
WA7097892Medicaid
WA7097892Medicaid