{
"Npi": {
"NPI": "1538211784",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MR. SHANE'S. INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "17735 15TH AVE NE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SHORELINE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98155-3803",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "206-364-1322",
"MailingAddressFaxNumber": "206-365-2074",
"FirstLinePracticeLocationAddress": "17735 15TH AVE NE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SHORELINE",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98155-3803",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "206-364-1322",
"PracticeLocationAddressFaxNumber": "206-365-2074",
"EnumerationDate": "01/17/2007",
"LastUpdateDate": "09/29/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HAYES",
"AuthorizedOfficialFirstName": "SHANE",
"AuthorizedOfficialMiddleName": "G.",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "CERTIFIED PEDORTHIST",
"AuthorizedOfficialTelephoneNumber": "206-364-1322",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "600559120",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}