{
"Npi": {
"NPI": "1699425504",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MARTINEZ",
"FirstName": "KENDRA",
"MiddleName": "MANZONI",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "ARNP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CROWE",
"OtherFirstName": "KENDRA",
"OtherMiddleName": "MANZONI",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "RN",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "17408 HALLMAN RD NW",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "POULSBO",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98370-8264",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "253-820-0271",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1780 NW MYHRE RD STE 1220",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SILVERDALE",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98383-8676",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-698-4500",
"PracticeLocationAddressFaxNumber": "360-698-6960",
"EnumerationDate": "03/24/2022",
"LastUpdateDate": "08/15/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "AP61436670",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LA2200X",
"TaxonomyName": "Adult Health Nurse Practitioner",
"LicenseNumber": "AP61436670",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}