{
"Npi": {
"NPI": "1356747323",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BALLABAN",
"FirstName": "ABIGAIL",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "AC169718",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "15524 NE HALSEY ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PORTLAND",
"MailingAddressStateName": "OR",
"MailingAddressPostalCode": "97230-5337",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "503-389-8938",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "12555 SW 1ST ST.",
"SecondLinePracticeLocationAddress": "SAGE CENTER",
"PracticeLocationAddressCityName": "BEAVERTON",
"PracticeLocationAddressStateName": "OR",
"PracticeLocationAddressPostalCode": "97005",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "503-389-8938",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/18/2014",
"LastUpdateDate": "10/19/2016",
"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": "171100000X",
"TaxonomyName": "Acupuncturist",
"LicenseNumber": "AC169718",
"LicenseNumberStateCode": "OR",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "171100000X",
"TaxonomyName": "Acupuncturist",
"LicenseNumber": "AC 60504025",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}