{
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"FirstLineMailingAddress": "PO BOX 1433",
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"MailingAddressCityName": "FRIDAY HARBOR",
"MailingAddressStateName": "WA",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "880 GUARD ST",
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"PracticeLocationAddressCityName": "FRIDAY HARBOR",
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"EnumerationDate": "03/26/2014",
"LastUpdateDate": "03/26/2014",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NICHOLS",
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"AuthorizedOfficialCredential": "OTR/L",
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"Taxonomy": {
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"TaxonomyName": "Occupational Therapist",
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"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}