{
"Npi": {
"NPI": "1023386828",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ELIZABETH NGUYEN, DC., LLC",
"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": "12766 SE STARK ST",
"SecondLineMailingAddress": "PLAZA 125 C",
"MailingAddressCityName": "PORTLAND",
"MailingAddressStateName": "OR",
"MailingAddressPostalCode": "97233-1539",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "503-232-2933",
"MailingAddressFaxNumber": "503-235-9736",
"FirstLinePracticeLocationAddress": "12766 SE STARK ST",
"SecondLinePracticeLocationAddress": "PLAZA 125 C",
"PracticeLocationAddressCityName": "PORTLAND",
"PracticeLocationAddressStateName": "OR",
"PracticeLocationAddressPostalCode": "97233-1539",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "503-232-2933",
"PracticeLocationAddressFaxNumber": "503-235-9736",
"EnumerationDate": "12/07/2011",
"LastUpdateDate": "12/07/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NGUYEN",
"AuthorizedOfficialFirstName": "ELIZABETH",
"AuthorizedOfficialMiddleName": "BAO NGOC",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "503-232-2933",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}