Provider Demographics
NPI:1104809276
Name:HAWKINS, JUNE M (MD)
Entity type:Individual
Prefix:
First Name:JUNE
Middle Name:M
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20561 S ADAMS VISTA CT
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-7358
Mailing Address - Country:US
Mailing Address - Phone:503-631-4302
Mailing Address - Fax:503-631-4035
Practice Address - Street 1:14279 GLEN OAK RD
Practice Address - Street 2:STE 204
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-8008
Practice Address - Country:US
Practice Address - Phone:503-631-4302
Practice Address - Fax:503-631-4035
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12758174400000X
ORMD12758207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR009196Medicaid
OR838724001OtherBCBS - INDIVIDUAL
OR12758OtherOREGON MEDICAL LICENSE
OR838724000OtherBCBS - GROUP
OR838724000OtherBCBS - GROUP
ORAH1102867OtherDEA