{
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"LastName": null,
"FirstName": null,
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"FirstLineMailingAddress": "1717 S J ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TACOMA",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98405-4933",
"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1717 S J ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TACOMA",
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"PracticeLocationAddressTelephoneNumber": "253-426-4300",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/19/2010",
"LastUpdateDate": "11/19/2010",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LAY",
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"AuthorizedOfficialTitle": "CLINICAL MANAGER",
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"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "253-426-6307",
"Taxonomies": {
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"TaxonomyName": "General Acute Care Hospital",
"LicenseNumber": "RN60082126",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}