Provider Demographics
NPI:1356220602
Name:HAWK, TAMARA LYNAE (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:LYNAE
Last Name:HAWK
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5658 E BLUE SKY DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85266-8605
Mailing Address - Country:US
Mailing Address - Phone:307-258-3095
Mailing Address - Fax:
Practice Address - Street 1:5658 E BLUE SKY DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85266-8605
Practice Address - Country:US
Practice Address - Phone:307-258-3095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-30
Last Update Date:2025-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ010874225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist