Provider Demographics
NPI:1164864930
Name:HAWLEY QUINN, DIANA D (MA)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:D
Last Name:HAWLEY QUINN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64728
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98464-0728
Mailing Address - Country:US
Mailing Address - Phone:253-254-4045
Mailing Address - Fax:253-736-9373
Practice Address - Street 1:5216 52ND ST W
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98467-3200
Practice Address - Country:US
Practice Address - Phone:253-254-4045
Practice Address - Fax:253-736-9373
Is Sole Proprietor?:No
Enumeration Date:2013-07-22
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
604035357OtherUBI