{"npi":"1982903142","type":"NPI-1","status":"active","name":{"display":"Dr. Dayne Mickelson M.D.","other":[],"first":"DAYNE","last":"MICKELSON","middle":"TIMOTHY","credential":"M.D."},"specialty":{"primary_taxonomy":"207X00000X","primary_taxonomy_description":"Orthopaedic Surgery","slug":"orthopedic-surgery","schema_org_specialty":"PlasticSurgery","all":[{"code":"207XX0005X","description":"Orthopaedic Sports Medicine","primary":false,"state":"WA","license":"MD60476167"},{"code":"207X00000X","description":"Orthopaedic Surgery","primary":true,"state":"WA","license":"MD60476167"}]},"addresses":[{"purpose":"LOCATION","street_1":"3101 NORTHUP WAY STE 201","city":"BELLEVUE","state":"WA","postal_code":"980041435","country_code":"US","phone":"4254553600","fax":"4254553920"},{"purpose":"MAILING","street_1":"510 8TH AVE NE STE 320","city":"ISSAQUAH","state":"WA","postal_code":"980295436","country_code":"US","phone":"4255070733"}],"license":{"state":"WA","number":"MD60476167"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"2018712","state":"WA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20170927004799","type_code":"14-20","type_desc":"PRACTITIONER - ORTHOPEDIC SURGERY","state":"WA","pac_id":"6709100506"}]},"enumeration_date":"2011-03-26","last_updated":"2024-05-23","_meta":{"source":"NPPES","snapshot_date":"2024-05-23","doc_url":"https://findmynpi.com/api"}}