Heather Juline Hawk, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP60930255 Issued in WA

Practice address

Peacehealth Medical Group
4545 Cordata Parkway, Suite 1B
Bellingham, WA 98226

Phone

(360) 752-5216

Fax

(360) 752-5669

NPI assigned

Dec 21, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Peacehealth

  • Internal Medicine Physician
  • Bellingham, WA
  • NPI 1356309553
  Medicare reassignment NPD
• Open Door Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Crescent City, CA
  • NPI 1497840656
  Medicare reassignment NPD
• Peacehealth

  • Sleep Disorder Diagnostic Clinic/Center
  • Bellingham, WA
  • NPI 1265692842
  NPD
• Open Door Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Eureka, CA
  • NPI 1669569109
  NPD
• Open Door Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Eureka, CA
  • NPI 1831713452
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1083159479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 9TH ST",
            "address_2": "SUITE 203",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955216248",
            "telephone_number": "707-826-8633",
            "fax_number": "707-826-8628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PEACEHEALTH MEDICAL GROUP",
            "address_2": "4545 CORDATA PARKWAY, SUITE 1B",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "98226",
            "telephone_number": "360-752-5216",
            "fax_number": "360-752-5669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "638 Main Street",
            "address_purpose": "LOCATION",
            "city": "Ferndale",
            "state": "CA",
            "postal_code": "955361157",
            "country_code": "US",
            "telephone_number": "707-786-4028",
            "fax_number": "707-786-9029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAWK",
        "first_name": "HEATHER",
        "middle_name": "JULINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95005626",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WA",
            "license": "AP60930255",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP60930255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Haustedt
• Janelle Christine Havelka, D.C.
• Dale Haveman, M.D
• Haven Womens Health
• Anthony James Havens Jr., DC
• Crystal E Hawkins
• Jordana Winn Hawkins, MD
• Tyson J. Hawkins, M.D.
• Sherry Lynn Hawthorne
• Andrew Hay, OTR/L

• Gerontology Nurse Practitioner in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Gerontology Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.