{
"Npi": {
"NPI": "1740560416",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "EK",
"FirstName": "JORDAN",
"MiddleName": "NATHANIEL",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MPT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "700 NE 87TH AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VANCOUVER",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98664-1913",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-882-2778",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2005 W MAIN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BATTLE GROUND",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98604-4311",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-882-2778",
"PracticeLocationAddressFaxNumber": "360-604-1740",
"EnumerationDate": "08/25/2011",
"LastUpdateDate": "12/11/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "37978",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "PT60305643",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}