{
"Npi": {
"NPI": "1043714660",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GYAWU-AMOATENG",
"FirstName": "SAMUEL",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PHARM.D",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "ANTO",
"OtherFirstName": "SAMUAL",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "4033 TALBOT RD S # RS",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RENTON",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98055-5772",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "425-690-3533",
"MailingAddressFaxNumber": "425-690-9147",
"FirstLinePracticeLocationAddress": "4033 TALBOT RD S",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RENTON",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98055-5772",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "425-690-3533",
"PracticeLocationAddressFaxNumber": "425-690-9147",
"EnumerationDate": "03/20/2018",
"LastUpdateDate": "01/12/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "PCT0014346",
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "PH61452011",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "1835X0200X",
"TaxonomyName": "Oncology Pharmacist",
"LicenseNumber": "PST.024337",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}