{
"Npi": {
"NPI": "1255545802",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PHILLIP E HARRISON DDS PS",
"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": "214 2ND ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WENATCHEE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98801-2197",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "509-663-4709",
"MailingAddressFaxNumber": "509-667-0601",
"FirstLinePracticeLocationAddress": "214 2ND ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WENATCHEE",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98801-2197",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "509-663-4709",
"PracticeLocationAddressFaxNumber": "509-667-0601",
"EnumerationDate": "05/10/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HARRISON",
"AuthorizedOfficialFirstName": "PHILLIP",
"AuthorizedOfficialMiddleName": "E",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "509-663-4709",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "DE00006210",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}