Provider Demographics
NPI:1639151376
Name:HANKINS, CORINDA M (MD)
Entity Type:Individual
Prefix:
First Name:CORINDA
Middle Name:M
Last Name:HANKINS
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 1:810 13TH ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1210
Mailing Address - Country:US
Mailing Address - Phone:541-386-2300
Mailing Address - Fax:541-436-4113
Practice Address - Street 1:810 13TH ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1210
Practice Address - Country:US
Practice Address - Phone:541-386-2300
Practice Address - Fax:541-436-4113
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD24351208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR218112Medicaid
OR277349Medicaid
OR218112Medicaid
OR277349Medicaid