{
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"OrgName": "IRENE CHEN OD CORP",
"LastName": null,
"FirstName": null,
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"FirstLineMailingAddress": "PO BOX 55247",
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"MailingAddressCityName": "SHORELINE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98155-0247",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "18021 15TH AVE NE STE 100",
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"PracticeLocationAddressCityName": "SHORELINE",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98155-3806",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "206-367-8883",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/21/2008",
"LastUpdateDate": "03/27/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHEN",
"AuthorizedOfficialFirstName": "IRENE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": "OD",
"AuthorizedOfficialTelephoneNumber": "260-351-8610",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Optometrist",
"LicenseNumber": "3115",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"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."
}
}
}
}