{
"Npi": {
"NPI": "1215273677",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FOSTER WELLNESS",
"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": "4300 36TH AVE W STE 130",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SEATTLE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98199-1675",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "206-856-4096",
"MailingAddressFaxNumber": "206-267-9491",
"FirstLinePracticeLocationAddress": "4300 36TH AVE W STE 130",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SEATTLE",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98199-1675",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "206-856-4096",
"PracticeLocationAddressFaxNumber": "206-267-9491",
"EnumerationDate": "12/12/2012",
"LastUpdateDate": "12/12/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LEWERENZ",
"AuthorizedOfficialFirstName": "GREG",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/PRACTITIONER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "EAMP, LMP",
"AuthorizedOfficialTelephoneNumber": "206-856-4096",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": "MA00023193",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "171100000X",
"TaxonomyName": "Acupuncturist",
"LicenseNumber": "AC60114046",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}