Individual provider Active NPI

Laara Van Bryce, D.C.

  • Chiropractor
  • Bellevue, WA
National Provider Identifier
1316169550
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1643 Issued in WA
Practice address
2223 112TH Ave NE Ste 201
Bellevue, WA 98004-2952
Phone
(425) 785-5504
Fax
(425) 785-5504
NPI assigned
May 3, 2007
Last updated
Mar 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1643 WA Primary

Addresses

Primary practice location

2223 112TH Ave NE Ste 201
Bellevue, WA 98004-2952

Mailing address

2223 112TH Ave NE Ste 201
Bellevue, WA 98004-2952
Phone (425) 785-5504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060126000244 WA Practitioner - Chiropractic 1759395015 Practice locations: Bellevue, WA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1643WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Unique Holistic Chiropractic Chiropractor CurrentSince May 7, 2023 Accepting new patients
Aaron a. Ilk, DC, Inc., PS Chiropractor Past Accepting new patients

Locations

2223 112th Ave NE
Ste 201
Bellevue, WA 98004
Phone (425) 785-5504

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1316169550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2223 112TH AVE NE STE 201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980042952",
            "telephone_number": "425-785-5504",
            "fax_number": "425-974-1543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2223 112TH AVE NE STE 201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980042952",
            "telephone_number": "425-785-5504",
            "fax_number": "425-785-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN BRYCE",
        "first_name": "LAARA",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "1643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.