{
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"FirstLineMailingAddress": "5430 91ST ST NE",
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"MailingAddressCityName": "MARYSVILLE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98270-2642",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "7209 265TH ST NW STE 201",
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"EnumerationDate": "03/06/2025",
"LastUpdateDate": "03/08/2025",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "EIDSNESS",
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"Taxonomies": {
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"TaxonomyName": "Dental Clinic/Center",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}