1770791667 NPI number — BONNIE CAREY L.AC.,O.M.D.

NPI Number: 1770791667
Health Care Provider/Practitioner: BONNIE CAREY L.AC.,O.M.D.

NPI Number : 1770791667 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1770791667",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CAREY",
    "FirstName": "BONNIE",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "L.AC.,O.M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "146 MCDOUGALL RD W",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MOSSYROCK",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98564-9416",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "360-983-8594",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "242 E STATE ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MOSSYROCK",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98564",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "360-983-8594",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/21/2007",
    "LastUpdateDate": "07/08/2007",
    "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": "171100000X",
          "TaxonomyName": "Acupuncturist",
          "LicenseNumber": "622",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "171100000X",
          "TaxonomyName": "Acupuncturist",
          "LicenseNumber": "10",
          "LicenseNumberStateCode": "CT",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}