Provider Demographics
NPI:1497774897
Name:LANGEL, BRYSON JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:BRYSON
Middle Name:JOHN
Last Name:LANGEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13035
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98508-3035
Mailing Address - Country:US
Mailing Address - Phone:360-352-9912
Mailing Address - Fax:360-352-9913
Practice Address - Street 1:2703 CAPITOL MALL DR SW
Practice Address - Street 2:SUITE 103
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-5097
Practice Address - Country:US
Practice Address - Phone:360-352-9912
Practice Address - Fax:360-352-9913
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034157111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA4832LAOtherREGENCE
WA1629267471OtherGROUP NPI
WA0163040OtherLABOR & INDUSTRIES
WAU93846Medicare UPIN
WA4832LAOtherREGENCE
WA8850673Medicare PIN