{
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"FirstLineMailingAddress": "305 S WARREN AVE",
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"FirstLinePracticeLocationAddress": "5809 HIGHWAY 2 STE 105",
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"PracticeLocationAddressCityName": "PRIEST RIVER",
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"EnumerationDate": "01/11/2021",
"LastUpdateDate": "01/11/2021",
"NPIDeactivationReasonCode": null,
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"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"LicenseNumberStateCode": "ID",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}