{
"Npi": {
"NPI": "1104007269",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BOEHM",
"FirstName": "RICK",
"MiddleName": "D",
"NamePrefix": "MR.",
"NameSuffix": null,
"Credential": "LMHC, MAC, MS",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "BOEHM",
"OtherFirstName": "RICKY",
"OtherMiddleName": "D",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "400 E EVERGREEN BLVD",
"SecondLineMailingAddress": "SUITE 108",
"MailingAddressCityName": "VANCOUVER",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98660-3331",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-906-8160",
"MailingAddressFaxNumber": "360-906-8194",
"FirstLinePracticeLocationAddress": "400 E EVERGREEN BLVD",
"SecondLinePracticeLocationAddress": "SUITE 108",
"PracticeLocationAddressCityName": "VANCOUVER",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98660-3331",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-906-8160",
"PracticeLocationAddressFaxNumber": "360-906-8194",
"EnumerationDate": "11/16/2007",
"LastUpdateDate": "04/16/2025",
"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": "101YA0400X",
"TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
"LicenseNumber": "MAC501835",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": "LH00005696",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "101YA0400X",
"TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
"LicenseNumber": "CP00002340",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}