{
"Npi": {
"NPI": "1003038266",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CHARLES GALLAGHER PT, PS",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "11402 N NEWPORT HWY",
"SecondLineMailingAddress": "SUITE B",
"MailingAddressCityName": "SPOKANE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "99218-1616",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "509-464-1813",
"MailingAddressFaxNumber": "509-464-4813",
"FirstLinePracticeLocationAddress": "11402 N NEWPORT HWY",
"SecondLinePracticeLocationAddress": "SUITE B",
"PracticeLocationAddressCityName": "SPOKANE",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "99218-1616",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "509-464-1813",
"PracticeLocationAddressFaxNumber": "509-464-4813",
"EnumerationDate": "05/03/2007",
"LastUpdateDate": "01/26/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GALLAGHER",
"AuthorizedOfficialFirstName": "JULIE",
"AuthorizedOfficialMiddleName": "ANN",
"AuthorizedOfficialTitle": "BILLING MANAGER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "209-464-1813",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": "PT00007501",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}