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CREEKSIDE MEDICAL, PS
NPI 1760529374
Internal Medicine in Vancouver, WA

Active since January 31, 2007CLIA 50D1031109 · Waiver
900 NE 139TH ST, SUITE 202, VANCOUVER, WA 98685(360) 566-9355(360) 816-1327 Get Directions Write a Review

NPPES record last updated: February 9, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Creekside Medical, Ps NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CREEKSIDE MEDICAL, PS (NPI 1760529374) is a healthcare organization registered as an internal medicine in Vancouver, Washington and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Michelle L Vincent, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1760529374
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCREEKSIDE MEDICAL, PS
Location Address900 NE 139TH ST, SUITE 202Vancouver, WA 98685-2513
Mailing Address900 Ne 139th St, Suite 202Vancouver, WA 98685-2513 · (360) 566-9355 · Fax (360) 816-1327
Phone(360) 566-9355
Fax(360) 816-1327
Organization SubpartNo
Authorized OfficialMichelle L VincentPractice Administrator · (360) 566-9355
Enumeration DateJanuary 31, 2007
Last NPPES UpdateFebruary 9, 2026
NPPES CertifiedFebruary 9, 2026
✔ NPI 1760529374 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
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.
Also ListedPediatricsTaxonomy 208000000X
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X
900 NE 139TH ST, Vancouver, WA 98685
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Oregon.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D1031109

Creekside Medical · Vancouver, WA
Active · expires Apr 4, 2028
CLIA Number50D1031109
Laboratory TypePhysician Office
Certificate Effective DateSeptember 23, 2004
Certificate Expiration DateApril 4, 2028
Laboratory DirectorSupranee A. Nopachai
Laboratory Phone(360) 566-9355
Laboratory LocationCreekside Medical900 NE 139th St Ste 202, Vancouver, WA 98685
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

S. AMY NOPACHAI M.D.
Internal Medicine
900 NE 139TH ST, SUITE 202
VANCOUVER, WA 98685
Clark County (360) 566-9355
JAMES ROBERTS MD
Internal Medicine
900 NE 139TH ST, SUITE 202
VANCOUVER, WA 98685
Clark County (360) 566-9355
AMANDA LOUISE CULVER DPT
Physical Therapist
900 NE 139TH ST, SUITE 102
VANCOUVER, WA 98685
Clark County (360) 573-3611
DR. JILL SPEAKER M.D.
Internal Medicine
900 NE 139TH ST, SUITE 202
VANCOUVER, WA 98685
Clark County (360) 566-9355
OLIVIA L. JONES D.O.
Internal Medicine
900 NE 139TH ST, SUITE 202
VANCOUVER, WA 98685
Clark County (360) 566-9355
ANNA POTOCZNY-JONES DPT
Physical Therapist
900 NE 139TH ST, SUITE 102
VANCOUVER, WA 98685
Clark County (360) 573-3611
HOLLY ILENA FABER TSE M.D.
Internal Medicine
900 NE 139TH ST, STE 202
VANCOUVER, WA 98685
Clark County (360) 566-9355
JESSICA T LY MD
Internal Medicine
900 NE 139TH ST, SUITE 202
VANCOUVER, WA 98685
Clark County (360) 566-9355

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Creekside Medical, Ps's NPI number?

The NPI number for Creekside Medical, Ps is 1760529374. It was assigned to this organization in the NPPES registry on January 31, 2007.

Where is Creekside Medical, Ps located?

Creekside Medical, Ps is located at 900 NE 139th St Suite 202, Vancouver, WA 98685. The listed phone number is (360) 566-9355.

What is Creekside Medical, Ps's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Creekside Medical, Ps hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D1031109) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Creekside Medical, Ps accept?

Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Oregon list Creekside Medical, Ps as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Creekside Medical, Ps was last updated on February 9, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.