Individual
MICHAEL JAMES HAWKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
3600 N INTERSTATE AVE, PORTLAND, OR 97227-1106
(503) 249-3429
Mailing address
644 N RUSSET ST, PORTLAND, OR 97217-1452
(503) 544-6401
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO2165
WA
Other
Enumeration date
08/21/2006
Last updated
07/08/2007
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