Individual
WILMA MCALVAIN HAWKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC II
Contact information
Practice address
404 NW 23RD ST, CORVALLIS, OR 97330-5539
(541) 753-7801
Mailing address
404 NW 23RD ST, CORVALLIS, OR 97330-5539
(541) 753-7801
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
21-06-20064
OR
175T00000X
Peer Specialist
Primary
THW000003007
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932794575
—
OR
Enumeration date
10/17/2018
Last updated
08/12/2021
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