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General NPI Number Information
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NPI Number | 1841458940
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Entity Type | Organization
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Legal Business Name | NORTHPOINTE FAMILY MEDICINE PLLC
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Dates
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Enumeration Date | 05/27/2008
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Last Update Date | 05/27/2008
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Provider Practice Location Address
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Address Line | 9631 N NEVADA ST STE 304
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City | SPOKANE
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State | WA
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Zip | 99218-3406
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Country | US
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Telephone | 509-466-1271
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Fax | 509-466-0969
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Provider Business Mailing Address
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Address Line | 9631 N NEVADA ST STE 304
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City | SPOKANE
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State | WA
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Zip | 99218-3406
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Country | US
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Telephone | 509-466-1271
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Fax | 509-466-0969
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL RANDOLPH
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Credential | MD
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Telephone | 509-466-1271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD0031792
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License Number State | WA
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