{
"Npi": {
"NPI": "1730607664",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "FISHER",
"FirstName": "ELISABETH",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MSN (APRN)",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GUNDELFINGER",
"OtherFirstName": "ELISABETH",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "MSN (APRN)",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "500 SW 7TH ST STE A205",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RENTON",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98057-2983",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "877-522-1275",
"MailingAddressFaxNumber": "833-888-7145",
"FirstLinePracticeLocationAddress": "8585 OLD DAIRY RD STE 200",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "JUNEAU",
"PracticeLocationAddressStateName": "AK",
"PracticeLocationAddressPostalCode": "99801-8094",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "877-522-1275",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/30/2017",
"LastUpdateDate": "02/26/2025",
"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": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "RN60297117",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "AP60794601",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LA2200X",
"TaxonomyName": "Adult Health Nurse Practitioner",
"LicenseNumber": "132431",
"LicenseNumberStateCode": "AK",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "132431",
"LicenseNumberStateCode": "AK",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LP2300X",
"TaxonomyName": "Primary Care Nurse Practitioner",
"LicenseNumber": "132431",
"LicenseNumberStateCode": "AK",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LW0102X",
"TaxonomyName": "Women's Health Nurse Practitioner",
"LicenseNumber": "132431",
"LicenseNumberStateCode": "AK",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "132431",
"LicenseNumberStateCode": "AK",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}