{
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"EIN": null,
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"FirstLineMailingAddress": "PO BOX 1656",
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"MailingAddressCityName": "ISSAQUAH",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98027-0066",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "425-221-5873",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1818 WESTLAKE AVE N",
"SecondLinePracticeLocationAddress": "SUITE 414",
"PracticeLocationAddressCityName": "SEATTLE",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "206-282-0172",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/10/2008",
"LastUpdateDate": "09/10/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Massage Therapist",
"LicenseNumber": "MA00012872",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}