{
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"FirstLineMailingAddress": "32717 1ST AVE S",
"SecondLineMailingAddress": "STE.6",
"MailingAddressCityName": "FEDERAL WAY",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98003-5758",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "253-838-5428",
"MailingAddressFaxNumber": "253-838-0875",
"FirstLinePracticeLocationAddress": "32717 1ST AVE S",
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"PracticeLocationAddressStateName": "WA",
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"PracticeLocationAddressTelephoneNumber": "253-838-5428",
"PracticeLocationAddressFaxNumber": "253-838-0875",
"EnumerationDate": "12/19/2006",
"LastUpdateDate": "06/06/2008",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHIN",
"AuthorizedOfficialFirstName": "BRENT",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialTelephoneNumber": "253-838-5428",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152WC0802X",
"TaxonomyName": "Corneal and Contact Management Optometrist",
"LicenseNumber": "OD00003778TX",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}