Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Cascade Park Sports Medicine & Rehab Clinic PLLC

Organization Chiropractor · NPI 1679641393

Cascade Park Sports Medicine & Rehab Clinic PLLC provides Chiropractor services in Vancouver, Washington. Licensed in Washington. Registered with an NPI since 2006.

Licensed in
WA
In the registry since
2006
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12214 SE Mill Plain Blvd Ste 101
Vancouver, WA 98684-6019 Not confirmed with CMS for 19 years — call before visiting
Phone: (360) 254-4040
Fax: (360) 253-7808
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Chiropractor (primary) Taxonomy 111N00000X · Licence CH00002108 (WA)

Record details

NPI number1679641393
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lucas Homer — Owner · (360) 254-4040
NPI enumeratedDecember 1, 2006
Last updated in NPPESSeptember 13, 2007
Mailing address12214 Se Mill Plain Blvd, Ste 101, Vancouver, WA 98684-6019

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