Active NPI
Autumn Hawkins
- Speech-Language Pathologist
- Portland, OR
National Provider Identifier
1609516939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 015870
- Practice address
- 6516 NE Siskiyou St
Portland, OR 97213-4572 - Phone
- (503) 568-1781
- NPI assigned
- Apr 1, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 015870 | OR | Primary |
Addresses
Primary practice location
6516 NE Siskiyou St
Portland, OR 97213-4572
Mailing address
3314 NE 15TH Ave
Portland, OR 97212-2305
Phone (812) 606-5270
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14181310 | Other | OR | AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION |
| 015870 | Other | OR | BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY & AUDIOLOGY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015870 | OR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648771200000",
"number": "1609516939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3314 NE 15TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972122305",
"telephone_number": "812-606-5270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6516 NE SISKIYOU ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972134572",
"telephone_number": "503-568-1781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAWKINS",
"first_name": "AUTUMN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-01",
"last_updated": "2022-04-01",
"certification_date": "2022-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OR",
"license": "015870",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION",
"identifier": "14181310",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY & AUDIOLOGY",
"identifier": "015870",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.