Provider Demographics
NPI:1376818302
Name:HAKERT, DANIKA FAWN
Entity Type:Individual
Prefix:
First Name:DANIKA
Middle Name:FAWN
Last Name:HAKERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FAWN
Other - Middle Name:
Other - Last Name:HAKERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:998 LIBRARY CT
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-4041
Mailing Address - Country:US
Mailing Address - Phone:503-655-8401
Mailing Address - Fax:503-556-8429
Practice Address - Street 1:998 LIBRARY CT
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-4041
Practice Address - Country:US
Practice Address - Phone:503-655-8401
Practice Address - Fax:503-556-8429
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-08
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
ORTHW1682175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator