{
"Npi": {
"NPI": "1700188935",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "PHILLIPS",
"FirstName": "HEATHER",
"MiddleName": "L",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LSCW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "BABBITT",
"OtherFirstName": "HEATHER",
"OtherMiddleName": "L",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "7650 SW BEVELAND RD STE 200",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PORTLAND",
"MailingAddressStateName": "OR",
"MailingAddressPostalCode": "97223-8692",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "503-601-3615",
"MailingAddressFaxNumber": "503-646-1683",
"FirstLinePracticeLocationAddress": "7431 NE EVERGREEN PKWY STE 100",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HILLSBORO",
"PracticeLocationAddressStateName": "OR",
"PracticeLocationAddressPostalCode": "97124-5831",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "503-840-3400",
"PracticeLocationAddressFaxNumber": "503-840-3409",
"EnumerationDate": "11/19/2010",
"LastUpdateDate": "04/08/2019",
"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": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "LW60248697",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "L7933",
"LicenseNumberStateCode": "OR",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}