Provider Demographics
NPI:1992429633
Name:HAWKINSON, JOEY SHANLEY (MA, SLP)
Entity type:Individual
Prefix:
First Name:JOEY
Middle Name:SHANLEY
Last Name:HAWKINSON
Suffix:
Gender:F
Credentials:MA, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 EVERSON GOSHEN RD RM 205A
Mailing Address - Street 2:
Mailing Address - City:EVERSON
Mailing Address - State:WA
Mailing Address - Zip Code:98247-9795
Mailing Address - Country:US
Mailing Address - Phone:360-966-2030
Mailing Address - Fax:
Practice Address - Street 1:216 EVERSON GOSHEN RD RM 205A
Practice Address - Street 2:
Practice Address - City:EVERSON
Practice Address - State:WA
Practice Address - Zip Code:98247-9795
Practice Address - Country:US
Practice Address - Phone:360-966-2030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASI61336065235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist