CREEKSIDE MEDICAL P.S. NPI 1760529374

NPI Information

  • NPI: 1760529374
  • Provider Name: CREEKSIDE MEDICAL, P.S.
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Organization
  • CLIA Number: 50D1031109
  • Address: 900 NE 139TH ST
    STE 202
    VANCOUVER, WA
    ZIP 98685
  • Phone: (360) 566-9355

Map and Directions

Get Directions

NPI Details

CREEKSIDE MEDICAL, P.S. is an internal medicine in Vancouver, WA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. CREEKSIDE MEDICAL, P.S. NPI is 1760529374. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

900 NE 139TH ST
STE 202
VANCOUVER, WA
ZIP 98685-513
Phone: (360) 566-9355
Fax: (360) 816-1327

The provider's authorized official is Carol Davis .
The authorized official title is Clinic Manager and has the following contact phone number (360) 566-9355.

The CLIA number assigned to this NPI record is 50D1031109 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/31/2007 and was last updated on 7/23/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedicalWASHINGTONNo
2208000000XPediatricsWASHINGTONNo
3207R00000XInternal MedicineWASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11760529374MEDICARE PINWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI