{
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "SUMAS CLINIC, INC. P.S.",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "PO BOX 1010",
"SecondLineMailingAddress": "112 COLUMBIA ST.",
"MailingAddressCityName": "SUMAS",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98295-1010",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-988-9404",
"MailingAddressFaxNumber": "360-988-9409",
"FirstLinePracticeLocationAddress": "112 COLUMBIA ST.",
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"PracticeLocationAddressCityName": "SUMAS",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-988-9404",
"PracticeLocationAddressFaxNumber": "360-988-9409",
"EnumerationDate": "07/31/2007",
"LastUpdateDate": "07/06/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "THOMPSON",
"AuthorizedOfficialFirstName": "RODNEY",
"AuthorizedOfficialMiddleName": "LEE BRIAN",
"AuthorizedOfficialTitle": "PHYSICIAN/PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "360-988-9404",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "MD00039892",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X 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."
}
}
}
}