{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "OLYMPIA IMAGING CENTER",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3425 ENSIGN RD NE",
"SecondLineMailingAddress": "STE320",
"MailingAddressCityName": "OLYMPIA",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98506-5425",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-491-1494",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3425 ENSIGN RD NE",
"SecondLinePracticeLocationAddress": "STE320",
"PracticeLocationAddressCityName": "OLYMPIA",
"PracticeLocationAddressStateName": "WA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-491-1494",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/10/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LAWTON",
"AuthorizedOfficialFirstName": "RODGER",
"AuthorizedOfficialMiddleName": "A",
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"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "D.M.D.",
"AuthorizedOfficialTelephoneNumber": "360-491-1494",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR0200X",
"TaxonomyName": "Radiology Clinic/Center",
"LicenseNumber": "602643",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}