{
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"ReplacementNPI": null,
"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "KITSAP PODIATRY PLLC",
"LastName": null,
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"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "10049 KITSAP MALL BLVD NW STE 109",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SILVERDALE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98383-8901",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-698-2505",
"MailingAddressFaxNumber": "360-698-2514",
"FirstLinePracticeLocationAddress": "10049 KITSAP MALL BLVD NW",
"SecondLinePracticeLocationAddress": "SUITE 109",
"PracticeLocationAddressCityName": "SILVERDALE",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98383-8903",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-698-2505",
"PracticeLocationAddressFaxNumber": "360-698-2514",
"EnumerationDate": "02/21/2008",
"LastUpdateDate": "01/08/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LINN",
"AuthorizedOfficialFirstName": "GEOFFREY",
"AuthorizedOfficialMiddleName": "RICHARD",
"AuthorizedOfficialTitle": "OWNER/PHYSICIAN",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPM",
"AuthorizedOfficialTelephoneNumber": "360-698-2505",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "213E00000X",
"TaxonomyName": "Podiatrist",
"LicenseNumber": null,
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}