{
"Npi": {
"NPI": "1497944540",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "QUALITY PHYSICAL THERAPY, INC. P.S.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "120 E GEORGE HOPPER RD",
"SecondLineMailingAddress": "SUITE 220",
"MailingAddressCityName": "BURLINGTON",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98233-3125",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-757-9335",
"MailingAddressFaxNumber": "360-757-9886",
"FirstLinePracticeLocationAddress": "1838 S BURLINGTON BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BURLINGTON",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98233",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-757-9335",
"PracticeLocationAddressFaxNumber": "360-757-9886",
"EnumerationDate": "10/15/2007",
"LastUpdateDate": "05/21/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SPINK",
"AuthorizedOfficialFirstName": "ANN",
"AuthorizedOfficialMiddleName": "LARSON",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "P.T.",
"AuthorizedOfficialTelephoneNumber": "360-757-9335",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": "602177381",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}