{
"Npi": {
"NPI": "1093003667",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COLUMBIA LUTHERAN CHARITIES",
"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": "2111 EXCHANGE ST",
"SecondLineMailingAddress": "PHARMACY DEPARTMENT",
"MailingAddressCityName": "ASTORIA",
"MailingAddressStateName": "OR",
"MailingAddressPostalCode": "97103-3329",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "503-338-4011",
"MailingAddressFaxNumber": "503-338-7577",
"FirstLinePracticeLocationAddress": "2120 EXCHANGE ST",
"SecondLinePracticeLocationAddress": "STE 101",
"PracticeLocationAddressCityName": "ASTORIA",
"PracticeLocationAddressStateName": "OR",
"PracticeLocationAddressPostalCode": "97103-3365",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "503-338-4560",
"PracticeLocationAddressFaxNumber": "503-338-4559",
"EnumerationDate": "07/18/2011",
"LastUpdateDate": "03/15/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LAMAN",
"AuthorizedOfficialFirstName": "CHRISTOPHER",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PHARMACY MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "503-338-4011",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "RP-0002649-CS",
"LicenseNumberStateCode": "OR",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}