{
"Npi": {
"NPI": "1205147428",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "VALA HAYNES",
"FirstName": "BELEN",
"MiddleName": "NANCY",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "DPT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GARCIA",
"OtherFirstName": "BELEN",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "DPT",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "16083 SW UPPER BOONES FERRY RD",
"SecondLineMailingAddress": "SUITE 300",
"MailingAddressCityName": "TIGARD",
"MailingAddressStateName": "OR",
"MailingAddressPostalCode": "97224-7736",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "800-219-8835",
"MailingAddressFaxNumber": "503-639-9699",
"FirstLinePracticeLocationAddress": "17700 SE MILL PLAIN BLVD STE 150",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "VANCOUVER",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98683-7582",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-514-9383",
"PracticeLocationAddressFaxNumber": "360-514-0193",
"EnumerationDate": "06/23/2010",
"LastUpdateDate": "12/22/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "PT60518151",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "6307",
"LicenseNumberStateCode": "OR",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}