{
"Npi": {
"NPI": "1811529340",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "THE SPA AT ORCHARD HOUSE INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3610 81ST AVE SW",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "OLYMPIA",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98512-7402",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-790-7272",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2401 BRISTOL CT SW STE C104",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OLYMPIA",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98502-6037",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-956-0574",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/12/2020",
"LastUpdateDate": "02/12/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NOONAN",
"AuthorizedOfficialFirstName": "KELLI",
"AuthorizedOfficialMiddleName": "ANNE",
"AuthorizedOfficialTitle": "CE)",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "360-790-7272",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "175F00000X",
"TaxonomyName": "Naturopath",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}