{
"Npi": {
"NPI": "1316911563",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "EAST GRAYS HARBOR FIRE AND RESCUE",
"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": "PO BOX 717",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ELMA",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98541-0717",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-482-3143",
"MailingAddressFaxNumber": "360-482-3152",
"FirstLinePracticeLocationAddress": "428 STAMPER ROAD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ELMA",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98541",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-482-6266",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/15/2006",
"LastUpdateDate": "09/12/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "COON",
"AuthorizedOfficialFirstName": "JODY",
"AuthorizedOfficialMiddleName": "ANN",
"AuthorizedOfficialTitle": "ADMINISTRATIVE ASSISTANT CHIEF",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "360-482-4903",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "14D05",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}