{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "CITY OF KODIAK",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 3510",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SILVERDALE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98383-3510",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-394-7020",
"MailingAddressFaxNumber": "360-394-7099",
"FirstLinePracticeLocationAddress": "219 LOWER MILL BAY RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KODIAK",
"PracticeLocationAddressStateName": "AK",
"PracticeLocationAddressPostalCode": "99615-6352",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "907-486-8657",
"PracticeLocationAddressFaxNumber": "907-486-8600",
"EnumerationDate": "05/22/2007",
"LastUpdateDate": "08/11/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ELLIS",
"AuthorizedOfficialFirstName": "VICTORIA",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "AMBULANCE CLERK",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "907-486-8656",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "6200",
"LicenseNumberStateCode": "AK",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}