{
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"FirstLineMailingAddress": "8919 E BROADWAY AVE",
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"MailingAddressCityName": "SPOKANE VALLEY",
"MailingAddressStateName": "WA",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "8919 E BROADWAY AVE",
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"PracticeLocationAddressTelephoneNumber": "509-924-7374",
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"EnumerationDate": "02/02/2026",
"LastUpdateDate": "02/02/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HENDERSHOT",
"AuthorizedOfficialFirstName": "JARED",
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"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialCredential": "DC",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Chiropractor",
"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}