Individual
AUTUMN HAWKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6516 NE SISKIYOU ST, PORTLAND, OR 97213-4572
(503) 568-1781
Mailing address
3314 NE 15TH AVE, PORTLAND, OR 97212-2305
(812) 606-5270
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
015870
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015870
BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY & AUDIOLOGY
OR
01
—
14181310
AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION
OR
Enumeration date
04/01/2022
Last updated
04/01/2022
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