Headache & Migraine Care in Spokane
For adults with migraine or other headaches who want faster access, clearer answers, and more treatment options.
If migraines or other headaches are disrupting your life, getting help should not require months of waiting, multiple referrals, or guesswork.
At Northwest DPC & Headache, Dr. Michael Stewart provides specialized headache evaluation and treatment in Spokane, including medication guidance, Botox for chronic migraine, occipital nerve blocks, trigger point injections, and second-opinion care.
You can come to us for headache care only, or combine headache care with direct primary care. We also see patients with Traditional Medicare and Workers’ Comp/L&I for headache care.
Now scheduling new headache patients.
A Clear Path to Headache Care
If you want a more direct, more thoughtful approach to headaches and migraines — our clinic is for you.
We can help with:
New or worsening migraine
Headaches that are interfering with work, family, or daily life
Frequent headaches that are not well controlled
Uncertainty about the diagnosis
Interest in Botox or procedure-based treatment
A second opinion after feeling stuck
Treatment with new and novel migraine medications, such as CGRP therapy, neuromodulation devices, and others.
Headache care here is designed to be practical, accessible, and individualized.
What Care May Include
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For some patients, the biggest need is not just a long-term plan. It is getting relief when a headache has flared and is not responding to the usual tools.
For established patients, we work to offer same-day or next-day access when possible for acute rescue treatment in headaches without red flags requiring the Emergency Department. Depending on the situation, that may include:
Occipital nerve blocks
Trigger point injections
In-office neuromodulation
IM medications
Our goal is to help patients avoid unnecessary urgent care or emergency department visits when a headache can be managed safely and effectively in the clinic.
We are actively expanding our in-clinic rescue options over time so that patients with acute or resistant headaches have more practical treatment pathways available close to home.
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We evaluate and treat many common and complex headache conditions, including:
Chronic migraine
Migraine with or without aura
Menstrual migraine
Perimenopausal migraine
Tension-type headache
Cervicogenic headache
Occipital neuralgia
Cluster headache
Post-traumatic or post-concussive headache
Medication-overuse headache
Idiopathic intracranial hypertension
Other complex headache disorders
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Not every headache needs extensive testing, but some do.
Your visit may include a focused review of your headache history, symptom pattern, triggers, prior treatments, medication use, physical exam and determine whether there are features that suggest a need for:
Labs
Imaging
Sleep studies
Physical Therapy Evaluation
Other Evaluations, as needed
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Treatment may include both acute and preventive strategies. We also can use medication and non-medication strategies.
This incudes reviewing what you have already tried, adjusting current medications, considering newer options such as neuromodulation, CGRP-based therapies, treating any root causes of your headaches, and building a plan that is realistic for your symptoms, goals, and day-to-day life.
Care may also include identifying and treating any contributing factors such as sleep issues, neck pain, medication overuse, hormonal patterns, or other triggers that may be worsening headaches.
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For some patients, treatment goes beyond pills. Depending on the diagnosis and clinical situation, care may include:
Occipital nerve blocks
Trigger point injections
Botox for chronic migraine
Neuromodulation strategies
Other procedure-based options
The right treatment depends on the headache type, prior response to treatment, and whether your symptoms suggest that a more targeted approach may help.
Headache care is not just about prescribing one medication and hoping for the best. The goal is to understand your pattern, clarify the diagnosis, and build a treatment plan that makes sense for your life.
Transparent Pricing
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Headache-only membership: $95/month
Direct Primary Care + Headache membership: $175/month ($110+ $65/month)Membership includes benefits of covering the cost of clinic visits, allows direct text messaging to your physician during clinic hours, and discounts for labs and procedures.
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If you would prefer to not pay for a monthly membership, we charge per visit.
Headache intake visit: $350
60-minute visit for diagnosis, treatment planning, and initial recommendationsFollow-up visit: $240
40-minute follow-up for ongoing management and adjustmentProcedure-only follow-up visit: $120
Visit fee for focused procedural follow-up -
Below are for standard pricing. Primary care and headache care memberships come with discounts on the following procedures, as well as don’t require visit costs.
Occipital nerve block: $75 + visit cost
Trigger point injection: $50 + visit cost
Botox procedure fee: $160 + visit cost
Botox requires a prior intake visit.Superbills with CPT and ICD-10 codes are provided for patients who want to seek possible out-of-network reimbursement.
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We accept a limited number of Traditional Medicare patients. We can also bill Medigap coverage. We bill these traditionally, in line with Medicare billing requirements.
At this time, we are unable to see individuals with Medicare Advantage coverage.
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We see headaches related to work-related events. This can be a new headache, such as a post-concussion headache. Or it can be a worsening of a known headache or migraine disorder.
If you would like to see us for L&I-related headache care, please have your Occupational Medicine provider or Care Manager reach out to us or send a referral.
Why Patients Choose Northwest DPC & Headache
Faster Access
Many patients are able to get in within 1-2 weeks. Once established, we are usually able to get patients in quickly for rescue therapy with neuromodulation, medication management, and occipital nerve blocks/trigger point injections within a day.
Rescue Access
We can help established patients avoid the Emergency Department and Urgent Care visits which are frequently frustrating and expensive. We are continually adding rescue tools to our clinic.
A Physician Who Understands Both Complexity and Continuity
Dr. Michael Stewart is a board-certified internal medicine physician and also holds an Advanced Qualification in Headache Medicine, which fits the clinic’s broader approach to thoughtful, long-term care.
More Than One Treatment Path
Treatment may include lifestyle modifications, medication management, procedures, Botox, neuromodulation, and identification of contributing factors/triggers, rather than relying on a single option.
Botox for Chronic Migraine
A real option for people who are still struggling
If you have frequent migraines and feel like you have run out of good options, Botox may be worth discussing.
For many people with chronic migraine, the hardest part is not deciding whether they are interested — it is actually finding someone who can help them figure out whether they qualify, offers Botox consistently, and can work to get their insurance to cover the medication. At Northwest DPC & Headache, Botox is part of a thoughtful headache-care pathway, not a quick add-on. The goal is to make access simpler, explain clearly whether it fits your situation, and build a plan that makes sense if it does not.
Whether you need a diagnosis, a better treatment plan, a second opinion, or a more direct path to migraine care, Northwest DPC & Headache is here to help.
Ready to Have Control Over Your Headaches?
Brief FAQ
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No. You can schedule headache care on its own. If you are looking for Direct primary care, you can combine them, as well.
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We evaluate and treat many headache conditions, including migraine, chronic migraine, tension-type headache, cervicogenic headache, occipital neuralgia, post-traumatic headache, and other complex headache disorders.
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No referral is required for most patients seeking headache care.
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Yes. Botox is available for appropriate patients with chronic migraine. The first step is a headache intake visit to confirm the diagnosis, review prior treatments, and decide whether Botox is a good fit.
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Headache care is generally self-pay, with transparent pricing. Superbills are available for patients who want to request possible out-of-network reimbursement. You can also use HSA funds to pay for headache services.
We are also able to bill active L&I claims & Traditional Medicare.
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Yes. Telehealth follow-up is available for patients in Washington.
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The intake visit includes a focused review of your headache history, prior treatments, diagnosis, education on your headache type, evaluation of if imaging is needed, and a treatment plan tailored to your situation.