{
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"OrgName": "HARBOR CHILD AND FAMILY THERAPY, PLLC",
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"FirstLineMailingAddress": "3210 42ND AVE NW",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GIG HARBOR",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98335-8036",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "253-208-4258",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "6625 WAGNER WAY NW",
"SecondLinePracticeLocationAddress": "SUITE 250",
"PracticeLocationAddressCityName": "GIG HARBOR",
"PracticeLocationAddressStateName": "WA",
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"PracticeLocationAddressTelephoneNumber": "253-208-4258",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/15/2016",
"LastUpdateDate": "03/15/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WALKER",
"AuthorizedOfficialFirstName": "DAVID",
"AuthorizedOfficialMiddleName": "B",
"AuthorizedOfficialTitle": "MARRIAGE AND FAMILY THERAPIST",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LMFT",
"AuthorizedOfficialTelephoneNumber": "253-208-4258",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "LF00001897",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"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."
}
}
}
}