Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Creekside Medical LLC

Organization Electrodiagnostic Medicine Physician · NPI 1487167052

Creekside Medical LLC is an Electrodiagnostic Medicine Physician in Cheyenne, Wyoming. Registered with an NPI since 2017.

In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1910 Thomes Ave
Cheyenne, WY 82001-3527
Phone: (425) 890-6239
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Electrodiagnostic Medicine Physician (primary) Taxonomy 204R00000X

Record details

NPI number1487167052
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Matthew Wavra — Managing Member · (425) 890-6239
NPI enumeratedNovember 6, 2017
Last updated in NPPESSeptember 20, 2018
Mailing address4580 Klahanie Dr Se # 252, Issaquah, WA 98029-5812

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