{
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"EIN": null,
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"IsOrgSubpart": "N",
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"ParentOrgTIN": null,
"OrgName": "ARGONAUT PEAK PHYSICAL THERAPY, INC. PS",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "PO BOX 2689",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WENATCHEE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98807-2689",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "509-260-1051",
"MailingAddressFaxNumber": "888-538-7694",
"FirstLinePracticeLocationAddress": "722 E UNIVERSITY WAY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ELLENSBURG",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98926-2947",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "509-962-1553",
"PracticeLocationAddressFaxNumber": "509-962-1554",
"EnumerationDate": "07/22/2008",
"LastUpdateDate": "05/13/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SUTTLES",
"AuthorizedOfficialFirstName": "JONATHAN",
"AuthorizedOfficialMiddleName": "T",
"AuthorizedOfficialTitle": "OWNER/PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MSPT",
"AuthorizedOfficialTelephoneNumber": "509-962-1553",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "PT00006580",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
}
}
}