{
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"EIN": null,
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"LastName": "DECLARK",
"FirstName": "MISTY",
"MiddleName": "APRIL ROBINSON",
"NamePrefix": "MRS.",
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"Credential": "M.S., L.M.F.T",
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "8321 NE 120TH PL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KIRKLAND",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98034-5824",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "425-820-6124",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "343 15TH AVE",
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"PracticeLocationAddressCityName": "KIRKLAND",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98033-5508",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "425-803-0907",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/13/2007",
"LastUpdateDate": "04/15/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
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"AuthorizedOfficialFirstName": null,
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "LF00001939",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}