Healthcare Provider Details

I. General information

NPI: 1578270609
Provider Name (Legal Business Name): ERIK HAMILTON PLOOF
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2022
Last Update Date: 10/28/2022
Certification Date: 10/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2370 130TH AVE NE STE 104
BELLEVUE WA
98005-1770
US

IV. Provider business mailing address

2370 130TH AVE NE STE 104
BELLEVUE WA
98005-1770
US

V. Phone/Fax

Practice location:
  • Phone: 425-628-2820
  • Fax:
Mailing address:
  • Phone: 425-628-2820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberMG61271406
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberMG61271406
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberMG61271406
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: