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

Impact Physician Group, Washington LLC

Organization Family Medicine Physician · NPI 1457008971

Impact Physician Group, Washington LLC is a Family Medicine Physician in Vancouver, Washington. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2
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

2805 NE 129th St
Vancouver, WA 98686-3324
Phone: (360) 356-1890
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Family Medicine Physician Taxonomy 207Q00000X

Record details

NPI number1457008971
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Paul Miller — Ceo · (678) 967-5599
NPI enumeratedMarch 4, 2022
Last updated in NPPESMarch 4, 2022
Certification dateMarch 4, 2022
Mailing address21 Eastbrook Bnd Ste 218, Peachtree City, GA 30269-1546

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