{
"Npi": {
"NPI": "1114316494",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WASHINGTON CARE AFH",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "147 NW 183RD ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SHORELINE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98177-3439",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "206-801-7174",
"MailingAddressFaxNumber": "206-801-7470",
"FirstLinePracticeLocationAddress": "16603 190TH AVE SE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RENTON",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98058-0814",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "425-282-4127",
"PracticeLocationAddressFaxNumber": "206-801-7470",
"EnumerationDate": "01/09/2015",
"LastUpdateDate": "01/09/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TANTOCO",
"AuthorizedOfficialFirstName": "ROLANDO",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PROVIDER/OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPN",
"AuthorizedOfficialTelephoneNumber": "206-801-7174",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3747A0650X",
"TaxonomyName": "Attendant Care Provider",
"LicenseNumber": "750929",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
}
}
}