{
"Npi": {
"NPI": "1104126523",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SMITH",
"FirstName": "KELLIE",
"MiddleName": "A",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PHARMD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "KUEHN",
"OtherFirstName": "KELLIE",
"OtherMiddleName": "A",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "PHARMD",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "611 N IRON BRIDGE WAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SPOKANE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "99202-4932",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "509-444-8888",
"MailingAddressFaxNumber": "509-444-7806",
"FirstLinePracticeLocationAddress": "3919 N MAPLE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SPOKANE",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "99205-1349",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "509-444-8200",
"PracticeLocationAddressFaxNumber": "509-434-0392",
"EnumerationDate": "11/02/2010",
"LastUpdateDate": "12/19/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "PH00052056",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}