{
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PAUL A. ZAVERUHA, MD, PS., INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 1080",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COUPEVILLE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98239-1080",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-678-6433",
"MailingAddressFaxNumber": "360-678-6812",
"FirstLinePracticeLocationAddress": "101 NE BIRCH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "COUPEVILLE",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98239-3133",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-678-6433",
"PracticeLocationAddressFaxNumber": "360-678-6812",
"EnumerationDate": "07/26/2010",
"LastUpdateDate": "11/28/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HILKEY",
"AuthorizedOfficialFirstName": "GAIL",
"AuthorizedOfficialMiddleName": "E",
"AuthorizedOfficialTitle": "BOOKKEEPER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "360-678-6433",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "174400000X",
"TaxonomyName": "Specialist",
"LicenseNumber": "MD00019657",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}