{
"Npi": {
"NPI": "1114056306",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TABOR INDUSTRIES, INC",
"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": "27 S STATE ST",
"SecondLineMailingAddress": "SUITE 240",
"MailingAddressCityName": "LAKE OSWEGO",
"MailingAddressStateName": "OR",
"MailingAddressPostalCode": "97034-3935",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "503-636-9608",
"MailingAddressFaxNumber": "503-636-9600",
"FirstLinePracticeLocationAddress": "2236 SE WASHINGTON ST",
"SecondLinePracticeLocationAddress": "SUITE D",
"PracticeLocationAddressCityName": "MILWAUKIE",
"PracticeLocationAddressStateName": "OR",
"PracticeLocationAddressPostalCode": "97222-7696",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "503-659-3305",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/05/2007",
"LastUpdateDate": "10/07/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TABOR",
"AuthorizedOfficialFirstName": "JANET",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "503-636-9608",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332H00000X",
"TaxonomyName": "Eyewear Supplier",
"LicenseNumber": "15143",
"LicenseNumberStateCode": "OR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}