{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "ASSIST IN A MIRACLE, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"Credential": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 212",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CLINTON",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98236-0212",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "425-971-3731",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "7149 MAXWELTON RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CLINTON",
"PracticeLocationAddressStateName": "WA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "425-971-3731",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/02/2017",
"LastUpdateDate": "06/02/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OGLE",
"AuthorizedOfficialFirstName": "CRYSTAL",
"AuthorizedOfficialMiddleName": "AMARYLLIS",
"AuthorizedOfficialTitle": "REGISTERED AGENT",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LM, CPM",
"AuthorizedOfficialTelephoneNumber": "425-971-3731",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "176B00000X",
"TaxonomyName": "Midwife",
"LicenseNumber": "MW60452672",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}