{
"Npi": {
"NPI": "1033283064",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "CRAIG D. DAHL D.C. INC. PS",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "17422 108TH AVE SE STE 102",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RENTON",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98055-5400",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "425-255-0427",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "17422 108TH AVE SE STE 102",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RENTON",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98055-5400",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "425-255-0427",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/20/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DAHL",
"AuthorizedOfficialFirstName": "CRAIG",
"AuthorizedOfficialMiddleName": "DAVID",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "253-797-4843",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "CH0003431",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}