Provider Demographics
NPI:1790983427
Name:HAWKINS, CATHERINE JOANNE (LMP)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:JOANNE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18336 AURORA AVE N
Mailing Address - Street 2:#111
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-4526
Mailing Address - Country:US
Mailing Address - Phone:206-542-3607
Mailing Address - Fax:206-542-3265
Practice Address - Street 1:18336 AURORA AVE N
Practice Address - Street 2:#111
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-4526
Practice Address - Country:US
Practice Address - Phone:206-542-3607
Practice Address - Fax:206-542-3265
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA0008862172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA38-3786781OtherTAX ID
WA#MA00008862OtherMASSAGE LICENSE