{
"Npi": {
"NPI": "1386160687",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SAN BUENAVENTURA",
"FirstName": "JOANNALYN",
"MiddleName": null,
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "PHARMACY TECHNICIAN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "RAMELB",
"OtherFirstName": "JOANNALYN",
"OtherMiddleName": null,
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "2737 DIAMOND ST UNIT A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MILTON",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98354-8348",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "253-347-9091",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1200 SW 27TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RENTON",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98057-2603",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "206-630-7910",
"PracticeLocationAddressFaxNumber": "877-224-4167",
"EnumerationDate": "08/17/2017",
"LastUpdateDate": "06/16/2018",
"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": "183700000X",
"TaxonomyName": "Pharmacy Technician",
"LicenseNumber": "VA00066211",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}