Individual
DR. ANNEKE P HATHAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
5050 NE HOYT ST, SUITE 422, PORTLAND, OR 97213-2991
(360) 263-5406
(360) 263-5406
Mailing address
PO BOX 87670, VANCOUVER, WA 98687-7670
(360) 263-5420
(360) 263-5406
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
636
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111955
—
OR
01
—
208446
VALUE OPTIONS
OR
Enumeration date
08/31/2006
Last updated
07/09/2007
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