Provider Demographics
NPI:1376197251
Name:HAWKINS, DENISE
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:DEESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6210 75TH ST W STE B100
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-8109
Mailing Address - Country:US
Mailing Address - Phone:253-345-5720
Mailing Address - Fax:
Practice Address - Street 1:7513 146TH ST SW APT 314
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98439-1213
Practice Address - Country:US
Practice Address - Phone:253-355-2484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst