{
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"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "PO BOX 87784",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VANCOUVER",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98687-7784",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-828-1378",
"MailingAddressFaxNumber": "360-834-1994",
"FirstLinePracticeLocationAddress": "406 SE 131ST AVE",
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"PracticeLocationAddressTelephoneNumber": "360-828-1378",
"PracticeLocationAddressFaxNumber": "360-834-1994",
"EnumerationDate": "02/24/2011",
"LastUpdateDate": "03/10/2011",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LEE",
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "360-281-0970",
"Taxonomies": {
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"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}