Provider Demographics
NPI:1629267471
Name:LANGEL CHIROPRACTIC, P.S.
Entity Type:Organization
Organization Name:LANGEL CHIROPRACTIC, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYSON
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:LANGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-943-6206
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:360-580-9235
Mailing Address - Fax:
Practice Address - Street 1:1645 COOPER POINT ROAD SW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502
Practice Address - Country:US
Practice Address - Phone:360-943-6206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034157111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G8944582OtherMEDICARE PTAN
WA4832LAOtherREGENCE
WA0163040OtherLABOR & INDUSTRIES
WA8850672Medicare PIN
WA0163040OtherLABOR & INDUSTRIES
WA8850673Medicare PIN