{
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"FirstLineMailingAddress": "PO BOX 1189",
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"MailingAddressStateName": "OR",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "35 MULLINS DRIVE",
"SecondLinePracticeLocationAddress": "SUITE 2",
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"EnumerationDate": "04/02/2012",
"LastUpdateDate": "05/05/2025",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RACKHAM",
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"AuthorizedOfficialTelephoneNumber": "541-451-7147",
"Taxonomies": {
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"TaxonomyName": "Rural Health Clinic/Center",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}