{
"Npi": {
"NPI": "1285249938",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "PARLE-FRESQUEZ",
"FirstName": "ANGELICA",
"MiddleName": "MARIA",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "M.A., CCC-SLP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "PARLE",
"OtherFirstName": "ANGELICA",
"OtherMiddleName": "MARIA",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "5908 NW 38TH AVE APT 213",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CAMAS",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98607-5410",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "713-305-0992",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "EARLY CHILDHOOD ASSESSMENT CENTER - LIESER SCHOOL",
"SecondLinePracticeLocationAddress": "301 S. LIESER RD",
"PracticeLocationAddressCityName": "VANCOUVER",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98664",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-313-4840",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/10/2020",
"LastUpdateDate": "09/10/2020",
"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": "235Z00000X",
"TaxonomyName": "Speech-Language Pathologist",
"LicenseNumber": "103695",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "235Z00000X",
"TaxonomyName": "Speech-Language Pathologist",
"LicenseNumber": "LL61097245",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}