{
"Npi": {
"NPI": "1629236773",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BELLINGHAM FAMILY EYE CLINIC PS",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "450-B BIRCHWOOD AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BELLINGHAM",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98225-1750",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-738-7700",
"MailingAddressFaxNumber": "360-733-5084",
"FirstLinePracticeLocationAddress": "450 BIRCHWOOD AVE STE B",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BELLINGHAM",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98225-1702",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-738-2020",
"PracticeLocationAddressFaxNumber": "360-733-5084",
"EnumerationDate": "05/27/2008",
"LastUpdateDate": "03/31/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GREEN",
"AuthorizedOfficialFirstName": "GLENN",
"AuthorizedOfficialMiddleName": "D",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OD",
"AuthorizedOfficialTelephoneNumber": "360-738-2020",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332H00000X",
"TaxonomyName": "Eyewear Supplier",
"LicenseNumber": "OD00001910",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}