{"npi":"1962776088","type":"NPI-1","status":"active","name":{"display":"Mr. Tyson Records PA-C","other":[],"first":"TYSON","last":"RECORDS","credential":"PA-C"},"specialty":{"primary_taxonomy":"363A00000X","primary_taxonomy_description":"Physician Assistant","slug":"physician-assistant","schema_org_specialty":null,"all":[{"code":"363AS0400X","description":"Surgical Physician Assistant","primary":false,"state":"WA","license":"PA60310447"},{"code":"363AS0400X","description":"Surgical Physician Assistant","primary":false,"state":"NY","license":"014858"},{"code":"363A00000X","description":"Physician Assistant","primary":true,"state":"WA","license":"PA60310447"}]},"addresses":[{"purpose":"LOCATION","street_1":"1717 S J ST","city":"TACOMA","state":"WA","postal_code":"984054933","country_code":"US","phone":"8443642778","fax":"2535668777"},{"purpose":"MAILING","street_1":"1717 S J ST","city":"TACOMA","state":"WA","postal_code":"984054933","country_code":"US","phone":"8443642778","fax":"2535668777"}],"license":{"state":"WA","number":"PA60310447"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"2023512","state":"WA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20121218000541","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"WA","pac_id":"7517119670"}]},"enumeration_date":"2012-03-07","last_updated":"2020-12-09","_meta":{"source":"NPPES","snapshot_date":"2020-12-09","doc_url":"https://findmynpi.com/api"}}