{
"Npi": {
"NPI": "1518059088",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CROWN",
"FirstName": "J",
"MiddleName": "R",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "O.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CROWN",
"OtherFirstName": "JENNIFER",
"OtherMiddleName": "R",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "OD",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "21126 SE 28TH PL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAMMAMISH",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98075-7417",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "503-806-1382",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "311 N 4TH ST STE 104",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "YAKIMA",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98901-2467",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "509-452-8301",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/29/2006",
"LastUpdateDate": "06/17/2025",
"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": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "OD00004103",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}