{
"Npi": {
"NPI": "1205011970",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HAND THERAPY SPECIALIST, LLC",
"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": "417 W MAIN ST STE B",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CENTRALIA",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98531-4263",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-807-0630",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3435 MARTIN WAY E STE C",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OLYMPIA",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98506-5071",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-923-5840",
"PracticeLocationAddressFaxNumber": "360-459-4836",
"EnumerationDate": "12/31/2007",
"LastUpdateDate": "12/31/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MENDIOLA",
"AuthorizedOfficialFirstName": "DANIEL",
"AuthorizedOfficialMiddleName": "C",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OTR/L, C,H.T.",
"AuthorizedOfficialTelephoneNumber": "360-923-5840",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "OT00000867",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}