Provider Demographics
NPI:1518183797
Name:HAWKINS, LAURENCETTA (LPN)
Entity Type:Individual
Prefix:
First Name:LAURENCETTA
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:LPN
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 66595
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97290-6595
Mailing Address - Country:US
Mailing Address - Phone:503-432-6288
Mailing Address - Fax:503-432-8266
Practice Address - Street 1:ALLIED HEALTH SERVICES
Practice Address - Street 2:16141 E BURNSIDE AVE
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233
Practice Address - Country:US
Practice Address - Phone:503-252-3949
Practice Address - Fax:503-252-4027
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse