{"npi":"1356326656","type":"NPI-1","status":"active","name":{"display":"Dr. Grant Tibbetts MD","other":[],"first":"GRANT","last":"TIBBETTS","middle":"PARKER","credential":"MD"},"specialty":{"primary_taxonomy":"2085R0202X","primary_taxonomy_description":"Diagnostic Radiology","slug":"diagnostic-radiology","schema_org_specialty":"Radiography","all":[{"code":"2085R0202X","description":"Diagnostic Radiology","primary":false,"state":"OR","license":"MD175166"},{"code":"2085R0202X","description":"Diagnostic Radiology","primary":true,"state":"WA","license":"MD60456798"}]},"addresses":[{"purpose":"LOCATION","street_1":"1304 FAWCETT AVE STE 100","city":"TACOMA","state":"WA","postal_code":"984021900","country_code":"US","phone":"2537614200","fax":"2537614201"},{"purpose":"MAILING","street_1":"PO BOX 1535","city":"TACOMA","state":"WA","postal_code":"984011535","country_code":"US","phone":"2537614200","fax":"2533833553"}],"license":{"state":"WA","number":"MD60456798"},"identifiers":[{"type_code":"01","label":"Other","value":"0394949","state":"WA","issuer":"L&I-DIAGNOSTIC IMAGING NW"},{"type_code":"01","label":"Other","value":"0335194","state":"WA","issuer":"L&I- TRA KING COUNTY"},{"type_code":"01","label":"Other","value":"0335196","state":"WA","issuer":"L&I-UNION AVE OPEN MRI"},{"type_code":"01","label":"Other","value":"0335106","state":"WA","issuer":"L&I-TRA PIERCE COUNTY"},{"type_code":"05","label":"Medicaid","value":"500698491","state":"OR","issuer":null},{"type_code":"05","label":"Medicaid","value":"2036409","state":"WA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20140623000353","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"WA","pac_id":"5193871630"},{"enrlmt_id":"I20251017000625","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"NC","pac_id":"5193871630"}]},"enumeration_date":"2005-12-08","last_updated":"2024-09-03","_meta":{"source":"NPPES","snapshot_date":"2024-09-03","doc_url":"https://findmynpi.com/api"}}