{
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"OrgName": "BELTONE HEARING CENTER",
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"FirstLineMailingAddress": "2310 MILDRED ST W",
"SecondLineMailingAddress": "STE, 134",
"MailingAddressCityName": "UNIVERSITY PLACE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98466-6036",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "253-565-0954",
"MailingAddressFaxNumber": "253-565-3300",
"FirstLinePracticeLocationAddress": "2310 MILDRED ST W",
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"PracticeLocationAddressCityName": "UNIVERSITY PLACE",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98466-6036",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "253-565-0954",
"PracticeLocationAddressFaxNumber": "253-565-3300",
"EnumerationDate": "07/07/2016",
"LastUpdateDate": "07/07/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SWANSON",
"AuthorizedOfficialFirstName": "AMANDA",
"AuthorizedOfficialMiddleName": "KIMBERLEY",
"AuthorizedOfficialTitle": "HEARING INSTRUMENT SPECIALIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "HIS",
"AuthorizedOfficialTelephoneNumber": "253-335-9366",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "237700000X",
"TaxonomyName": "Hearing Instrument Specialist",
"LicenseNumber": "HA60615539",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}