MEDICARE: DR. JENNIFER R HAWES N.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath	50	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	089718	OTHER	MT	BLUE CHIP PROVIDER NUMBER

General Provider Information

NPI Number	:	1497818991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER R HAWES N.D.

Provider Business Mailing Address
First Line	:	725 6TH AVE E
Second Line	:	#15
City	:	KALISPELL
State	:	MT
Zip	:	59901-5005
Country	:	US
Telephone Number	:	406-249-9997
Fax Number	:

Provider Business Practice Location Address
First Line	:	725 6TH AVE E
Second Line	:	#15
City	:	KALISPELL
State	:	MT
Zip	:	59901-5005
Country	:	US
Telephone Number	:	406-249-9997
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	07/08/2007

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