Provider Demographics
NPI:1669350195
Name:NORTHWEST DIRECT PRIMARY CARE, PLLC
Entity type:Organization
Organization Name:NORTHWEST DIRECT PRIMARY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:307-349-6005
Mailing Address - Street 1:610 W RAPTOR PEAK DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-5856
Mailing Address - Country:US
Mailing Address - Phone:307-349-6005
Mailing Address - Fax:
Practice Address - Street 1:1403 S GRAND BLVD STE 201S
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-2278
Practice Address - Country:US
Practice Address - Phone:509-903-5061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty