{
"Npi": {
"NPI": "1093282394",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "YOO",
"FirstName": "WONTAE",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "OD 60906377",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "430 S DUNN ST APT 209",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BLOOMINGTON",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "47401-4877",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "812-327-7807",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1810 S 320TH ST STE A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FEDERAL WAY",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98003-5639",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "812-327-7807",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/25/2018",
"LastUpdateDate": "10/27/2018",
"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": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "60906377",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}