Active NPI
Justin Lyle Sichula, MD
- Internal Medicine Physician
- Vancouver, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD61587710
- Practice address
- 2211 NE 139TH St
Vancouver, WA 98686-2742 - Phone
- (360) 487-1168
- Fax
- (503) 413-7361
- NPI assigned
- Mar 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | WA | ||
| Internal Medicine Physician | 207R00000X | MD61587710 | WA | Primary |
Addresses
Primary practice location
2211 NE 139TH St
Vancouver, WA 98686-2742
Mailing address
109 S Pearl St Apt 2
Ellensburg, WA 98926-4002
Phone (509) 856-4968
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2525 NE 139TH St
Vancouver, WA 98686-2719
Phone (360) 882-2778
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Vancouver Clinic Inc PS | Internal Medicine | Current | Accepting new patients |
| The Vancouver Clinic Inc PS | Current | Accepting new patients | |
| The Vancouver Clinic Inc PS | Current | Accepting new patients | |
| The Vancouver Clinic Pharmacy | Past | Accepting new patients |
Locations
700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500
2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985
2525 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1500
2525 NE 139th St
Ste 140
Vancouver, WA 98686
Phone (360) 822-2778
Interoperability endpoints
- jsichula19814@tvc-direct.org
- justin.sichula.1@18826.direct.athenahealth.com
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Vancouver, WA
- NPI 1992759427
-
- Ambulatory Surgical Clinic/Center
- Vancouver, WA
- NPI 1306556907
-
- Eyewear Supplier
- Ridgefield, WA
- NPI 1760004477
-
- Pharmacist
- Vancouver, WA
- NPI 1336365857
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750896000000",
"number": "1013666809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 S PEARL ST APT 2",
"city": "ELLENSBURG",
"state": "WA",
"postal_code": "989264002",
"telephone_number": "509-856-4968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2211 NE 139TH ST",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986862742",
"telephone_number": "360-487-1168",
"fax_number": "503-413-7361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SICHULA",
"first_name": "JUSTIN",
"middle_name": "LYLE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-21",
"last_updated": "2025-06-26",
"certification_date": "2025-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "WA",
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD61587710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.