Provider Demographics
NPI:1811388531
Name:HAWKINS, ANNA (LMFT)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5012 NE CLEVELAND AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-2660
Mailing Address - Country:US
Mailing Address - Phone:503-564-8393
Mailing Address - Fax:
Practice Address - Street 1:5015 SE HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-3255
Practice Address - Country:US
Practice Address - Phone:503-564-8393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT1022106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist