Provider Demographics
NPI:1902950314
Name:HAWKINS, MELISSA WILSON (PHD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:WILSON
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3824 38TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-1106
Mailing Address - Country:US
Mailing Address - Phone:206-725-0750
Mailing Address - Fax:206-760-1180
Practice Address - Street 1:2033 MINOR AVE E
Practice Address - Street 2:SUITE 5
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3574
Practice Address - Country:US
Practice Address - Phone:206-725-0750
Practice Address - Fax:206-760-1180
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY3450103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical