{
"Npi": {
"NPI": "1558640748",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "DARNELL",
"FirstName": "ASHLEY",
"MiddleName": "DAWN",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "DPT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GUSTAFSON",
"OtherFirstName": "ASHLEY",
"OtherMiddleName": "DAWN",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "DPT",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "915 118TH AVE SE STE 110",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BELLEVUE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98005-3875",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "425-450-9474",
"MailingAddressFaxNumber": "425-452-0704",
"FirstLinePracticeLocationAddress": "1804 W UNION AVE",
"SecondLinePracticeLocationAddress": "STE 101",
"PracticeLocationAddressCityName": "TACOMA",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98405-2062",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "532-512-5572",
"PracticeLocationAddressFaxNumber": "253-393-9187",
"EnumerationDate": "08/05/2011",
"LastUpdateDate": "09/10/2019",
"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": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "PT60229097",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}