{
"Npi": {
"NPI": "1396390845",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PENNY LEAH TANNER, P.S.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "38103 MOUNTAIN HWY E",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "EATONVILLE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98328-9202",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "253-581-6106",
"MailingAddressFaxNumber": "360-832-6211",
"FirstLinePracticeLocationAddress": "38103 MOUNTAIN HWY E",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EATONVILLE",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98328-9202",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "253-581-6106",
"PracticeLocationAddressFaxNumber": "360-832-6211",
"EnumerationDate": "08/01/2019",
"LastUpdateDate": "01/22/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TANNER",
"AuthorizedOfficialFirstName": "PENNY",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "P.S",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "ARNP,PH.D.,PMHNP-BC",
"AuthorizedOfficialTelephoneNumber": "253-581-6106",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}