Provider Demographics
NPI:1023457892
Name:HAWK, LAUREN GAIL (RN)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:GAIL
Last Name:HAWK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4908 N AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203-4408
Mailing Address - Country:US
Mailing Address - Phone:503-975-0966
Mailing Address - Fax:
Practice Address - Street 1:4345 WESTBAY RD
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-5525
Practice Address - Country:US
Practice Address - Phone:503-636-4488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201041311RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse