Provider Demographics
NPI:1841458940
Name:NORTHPOINTE FAMILY MEDICINE PLLC
Entity type:Organization
Organization Name:NORTHPOINTE FAMILY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RANDOLPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-466-1271
Mailing Address - Street 1:9631 N NEVADA ST STE 304
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-3406
Mailing Address - Country:US
Mailing Address - Phone:509-466-1271
Mailing Address - Fax:509-466-0969
Practice Address - Street 1:9631 N NEVADA ST STE 304
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-3406
Practice Address - Country:US
Practice Address - Phone:509-466-1271
Practice Address - Fax:509-466-0969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD0031792207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty