{
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"FirstLineMailingAddress": "PO BOX 259",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NAPAVINE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98565-0259",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-262-3320",
"MailingAddressFaxNumber": "360-262-3893",
"FirstLinePracticeLocationAddress": "2490 U.S. HWY 12",
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"PracticeLocationAddressFaxNumber": "360-985-7475",
"EnumerationDate": "01/31/2007",
"LastUpdateDate": "02/12/2008",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WOLFE",
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"AuthorizedOfficialTelephoneNumber": "360-262-3320",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Land Ambulance",
"LicenseNumber": "21D08",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}