{
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"FirstLineMailingAddress": "2207 N MOLTER RD",
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"MailingAddressStateName": "WA",
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"FirstLinePracticeLocationAddress": "2207 N MOLTER RD",
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"EnumerationDate": "09/25/2007",
"LastUpdateDate": "10/04/2011",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MANSON",
"AuthorizedOfficialFirstName": "TIMOTHY",
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"AuthorizedOfficialTelephoneNumber": "509-921-7755",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Sports Medicine (Family Medicine) Physician",
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"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."
}
}
}
}