Healthcare Provider Details

I. General information

NPI: 1801622014
Provider Name (Legal Business Name): HEATHER LYNN HANKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2024
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11010 SE DIVISION ST STE 202
PORTLAND OR
97266-6400
US

IV. Provider business mailing address

5441 S MACADAM AVE STE R
PORTLAND OR
97239-3822
US

V. Phone/Fax

Practice location:
  • Phone: 503-335-5975
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberA15672
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: