{
"Npi": {
"NPI": "1295073997",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BELLEVUE HYPERBARICS,PLLC",
"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": "1515 116TH AVE NE",
"SecondLineMailingAddress": "SUITE 202",
"MailingAddressCityName": "BELLEVUE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98004-3811",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "425-313-4800",
"MailingAddressFaxNumber": "425-312-1564",
"FirstLinePracticeLocationAddress": "1515 116TH AVE NE",
"SecondLinePracticeLocationAddress": "SUITE 202",
"PracticeLocationAddressCityName": "BELLEVUE",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98004-3811",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "425-313-4800",
"PracticeLocationAddressFaxNumber": "425-312-1564",
"EnumerationDate": "01/30/2013",
"LastUpdateDate": "02/05/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SMITH",
"AuthorizedOfficialFirstName": "LATISHA",
"AuthorizedOfficialMiddleName": "ANTOINETTE",
"AuthorizedOfficialTitle": "MANAGER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "425-313-4800",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM2500X",
"TaxonomyName": "Medical Specialty Clinic/Center",
"LicenseNumber": "60192681",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}