MEDICARE: MS. LEE ANN HAWKINS APRN, BC

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	364SP0809X	Adult Psychiatric/Mental Health Clinical Nurse Specialist	209003516(41202399)	IL
2	364SP0809X	Adult Psychiatric/Mental Health Clinical Nurse Specialist	60677450	WA
3	364SP0809X	Adult Psychiatric/Mental Health Clinical Nurse Specialist	201909919	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14219355	OTHER		CAQH ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881637544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LEE ANN HAWKINS APRN, BC

Provider Business Mailing Address
First Line	:	10260 SW GREENBURG RD FL 4
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97223-5500
Country	:	US
Telephone Number	:	646-941-7645
Fax Number	:

Provider Business Practice Location Address
First Line	:	10260 SW GREENBURG RD FL 4
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97223-5500
Country	:	US
Telephone Number	:	646-941-7645
Fax Number	:

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

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	07/29/2025

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