{
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"EIN": null,
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"IsOrgSubpart": "N",
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"FirstLineMailingAddress": "2015 152ND AVE NE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "REDMOND",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98052-5521",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-999-5635",
"MailingAddressFaxNumber": "360-395-2995",
"FirstLinePracticeLocationAddress": "1337 GOLDENROD RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BURLINGTON",
"PracticeLocationAddressStateName": "WA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-999-5635",
"PracticeLocationAddressFaxNumber": "360-395-2995",
"EnumerationDate": "05/20/2021",
"LastUpdateDate": "12/06/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GALLION",
"AuthorizedOfficialFirstName": "JOEL",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "425-451-2842",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332BX2000X",
"TaxonomyName": "Oxygen Equipment & Supplies (DME)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}