Provider Demographics
NPI:1396926887
Name:HAWKINS, SANDI L (LMP)
Entity type:Individual
Prefix:
First Name:SANDI
Middle Name:L
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5083 DAVID RD NW
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-8860
Mailing Address - Country:US
Mailing Address - Phone:360-649-8270
Mailing Address - Fax:
Practice Address - Street 1:5083 DAVID RD NW
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312-8860
Practice Address - Country:US
Practice Address - Phone:360-649-8270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-26
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024742172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist