{
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"FirstLineMailingAddress": "1205 BELLEVUE AVE",
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"FirstLinePracticeLocationAddress": "1205 BELLEVUE AVE",
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"EnumerationDate": "05/11/2017",
"LastUpdateDate": "05/11/2017",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MASON",
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"AuthorizedOfficialCredential": "LPC",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}