{
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"OrgName": "PAUL ANDREW SUENO MD PLLC",
"LastName": null,
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"FirstLineMailingAddress": "PO BOX 110518",
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"MailingAddressCityName": "TACOMA",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98411-0518",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2411 S 19TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TACOMA",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98405-2954",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "253-302-5189",
"PracticeLocationAddressFaxNumber": "253-302-5940",
"EnumerationDate": "04/30/2012",
"LastUpdateDate": "04/24/2013",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SUENO",
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"AuthorizedOfficialCredential": "MD",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM2500X",
"TaxonomyName": "Medical Specialty Clinic/Center",
"LicenseNumber": "MD60252648",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}