{
"Npi": {
"NPI": "1417137753",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BERMAN",
"FirstName": "TAMMIE",
"MiddleName": "WEGNER",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "PTA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4616 244TH STREET CT E",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GRAHAM",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98338-8359",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "253-961-6665",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "13954 NE 60TH WAY",
"SecondLinePracticeLocationAddress": "SUITE 110",
"PracticeLocationAddressCityName": "REDMOND",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98052-4583",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "425-890-0998",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/04/2007",
"LastUpdateDate": "11/04/2007",
"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": "171W00000X",
"TaxonomyName": "Contractor",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}