Provider Demographics
NPI:1548238603
Name:HAWLEY, VIRGINIA L (MD)
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:L
Last Name:HAWLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24769 NW WEST UNION RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-8527
Mailing Address - Country:US
Mailing Address - Phone:503-647-5510
Mailing Address - Fax:503-647-9364
Practice Address - Street 1:24769 NW WEST UNION RD
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-8527
Practice Address - Country:US
Practice Address - Phone:503-647-5510
Practice Address - Fax:503-647-9364
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD08685207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDG505503Medicaid
CAXPY204592Medicaid
OR050028686OtherRR MEDICARE
AKMD685ORMedicaid
WA1357508Medicaid
OR084434Medicaid
AKMD685ORMedicaid
OR084434Medicaid