Provider Demographics
NPI:1598087736
Name:HAWLEY, KARA (LMP)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:HAWLEY
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43335 KALIFORNSKY BEACH RD STE 25
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-8280
Mailing Address - Country:US
Mailing Address - Phone:907-903-3629
Mailing Address - Fax:907-262-0474
Practice Address - Street 1:43335 KALIFORNSKY BEACH RD
Practice Address - Street 2:STE 25
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669
Practice Address - Country:US
Practice Address - Phone:907-903-3629
Practice Address - Fax:907-262-0474
Is Sole Proprietor?:No
Enumeration Date:2010-02-15
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK112388225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist