{
"Npi": {
"NPI": "1306214598",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CHIROPRACTIC SYNERGY LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "12737 BEL RED RD",
"SecondLineMailingAddress": "SUITE 210",
"MailingAddressCityName": "BELLEVUE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98005-2699",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "206-552-8351",
"MailingAddressFaxNumber": "206-858-8278",
"FirstLinePracticeLocationAddress": "12737 BEL RED RD",
"SecondLinePracticeLocationAddress": "SUITE 210",
"PracticeLocationAddressCityName": "BELLEVUE",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98005-2699",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "206-552-8351",
"PracticeLocationAddressFaxNumber": "206-858-8278",
"EnumerationDate": "09/04/2015",
"LastUpdateDate": "05/17/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VO",
"AuthorizedOfficialFirstName": "JOHN-NAM",
"AuthorizedOfficialMiddleName": "THANH",
"AuthorizedOfficialTitle": "OWNER/DOCTOR OF CHIROPRACTIC",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "206-552-8351",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "302F00000X",
"TaxonomyName": "Exclusive Provider Organization",
"LicenseNumber": "60504206",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}