Marc Y Van Driessche, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3284 Issued in WA

Practice address

12704 Mukilteo Speedway Ste C
Mukilteo, WA 98275-5720

Phone

(425) 290-1919

Fax

(425) 353-9690

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Van Driessche Chiropractic P S

  • Preferred Provider Organization
  • Mukilteo, WA
  • NPI 1184884108
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1417041419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12704 MUKILTEO SPEEDWAY STE C",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982755720",
            "telephone_number": "425-290-1919",
            "fax_number": "425-353-9690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12704 MUKILTEO SPEEDWAY STE C",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982755720",
            "telephone_number": "425-290-1919",
            "fax_number": "425-353-9690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DRIESSCHE",
        "first_name": "MARC",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "3284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS NUMBER",
            "identifier": "2019560",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adonijah Twigg, LMP
• Jason Ulrich
• Molly Ulrich, LMT
• Elizabeth Michelle Valentine IV, M.S., R. PH.
• Van Driessche Chiropractic P S
• Kellye S Vaughn, LMP
• Brittany Velaborja, MA, LMFT
• Mario Alberto Velasquez, DNP, ARNP, PMHNP-BC
• Michael Virata, PTA
• Laurel Vogel, M.A.

• Chiropractor in Mukilteo, WA
• Providers in Mukilteo, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.