{
"Npi": {
"NPI": "1992063945",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RANDALL 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": "19721 SCRIBER LAKE RD STE D",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LYNNWOOD",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98036-6119",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "425-775-3544",
"MailingAddressFaxNumber": "425-670-6502",
"FirstLinePracticeLocationAddress": "19721 SCRIBER LAKE RD",
"SecondLinePracticeLocationAddress": "#D",
"PracticeLocationAddressCityName": "LYNNWOOD",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98036",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "425-775-3544",
"PracticeLocationAddressFaxNumber": "425-670-6502",
"EnumerationDate": "04/27/2012",
"LastUpdateDate": "04/27/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DREESSEN",
"AuthorizedOfficialFirstName": "RANDALL",
"AuthorizedOfficialMiddleName": "G",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "425-775-3544",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "305R00000X",
"TaxonomyName": "Preferred Provider Organization",
"LicenseNumber": "2221",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}