{
"Npi": {
"NPI": "1750802393",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SWANSON",
"FirstName": "CHRISTOPHER",
"MiddleName": "PAUL",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 421",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LIBERTY LAKE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "99019-0421",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "509-747-2455",
"MailingAddressFaxNumber": "509-227-7070",
"FirstLinePracticeLocationAddress": "551 E HAWTHORNE RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SPOKANE",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "99218-1417",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "509-252-1900",
"PracticeLocationAddressFaxNumber": "509-227-7070",
"EnumerationDate": "07/05/2017",
"LastUpdateDate": "04/07/2021",
"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": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "PA60806997",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}