{
"Npi": {
"NPI": "1801973219",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ROCK",
"FirstName": "TAJ",
"MiddleName": "MAHALIA",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "PHYSICIAN ASSISTANT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CHEROKE",
"OtherFirstName": "TAJ",
"OtherMiddleName": "MAHALIA",
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "9710 5TH AVE NE",
"SecondLineMailingAddress": "#201",
"MailingAddressCityName": "SEATTLE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98115",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "206-604-0160",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "12303 NE 130 LN",
"SecondLinePracticeLocationAddress": "#330 EVERGREEN DERMATOLOGY CENTER",
"PracticeLocationAddressCityName": "KIRKLAND",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98034",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "425-899-4300",
"PracticeLocationAddressFaxNumber": "425-899-4305",
"EnumerationDate": "11/01/2006",
"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": "207N00000X",
"TaxonomyName": "Dermatology Physician",
"LicenseNumber": "MD00029104",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "207N00000X",
"TaxonomyName": "Dermatology Physician",
"LicenseNumber": "3125",
"LicenseNumberStateCode": "AK",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}