{
"Npi": {
"NPI": "1811465651",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SAMEK",
"FirstName": "SUSAN",
"MiddleName": "R",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "AA, RN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "COLEY",
"OtherFirstName": "SUSAN",
"OtherMiddleName": "R",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "107 S DIVISION ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SPOKANE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "99202-1510",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "509-838-4651",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "107 S DIVISION ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SPOKANE",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "99202-1510",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "509-838-4651",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/09/2018",
"LastUpdateDate": "12/19/2018",
"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": "163WA2000X",
"TaxonomyName": "Administrator Registered Nurse",
"LicenseNumber": "RN00085792",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "RN00085792",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}