{
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"OrgName": "COOPER UROLOGY, INC. PS",
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"FirstLineMailingAddress": "1611 BUCK WAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MOUNT VERNON",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98273-2596",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-424-2180",
"MailingAddressFaxNumber": "360-428-3675",
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"PracticeLocationAddressCityName": "MOUNT VERNON",
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"EnumerationDate": "08/16/2007",
"LastUpdateDate": "08/16/2007",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PRESTON",
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"AuthorizedOfficialTelephoneNumber": "360-424-2180",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Urology Physician",
"LicenseNumber": "MD00013050",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"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."
}
}
}
}