Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | DO00002020 | WA |
NPI | 1124110010 |
---|---|
Provider Name | Ms. Dannica Joanne Hawes |
First Address | Hillsboro, OR 97124-7076 |
Second Address | Portland, OR 97266-8707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 08/07/2007 |