Provider Demographics
NPI:1811036163
Name:HAWKINS, MELVIN (MSW)
Entity Type:Individual
Prefix:
First Name:MELVIN
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 NE 68TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-4957
Mailing Address - Country:US
Mailing Address - Phone:503-988-3460
Mailing Address - Fax:503-988-4664
Practice Address - Street 1:1401 NE 68TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-4957
Practice Address - Country:US
Practice Address - Phone:503-988-3460
Practice Address - Fax:503-988-4664
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA1586104100000X
OR101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health