Healthcare Provider Details

I. General information

NPI: 1922674464
Provider Name (Legal Business Name): LUZVIMINDA HOFF RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2021
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15503 8TH AVE NE
SHORELINE WA
98155-6238
US

IV. Provider business mailing address

15527 BURKE AVE N
SHORELINE WA
98133-6032
US

V. Phone/Fax

Practice location:
  • Phone: 206-295-4783
  • Fax: 206-364-0493
Mailing address:
  • Phone: 206-295-4783
  • Fax: 206-364-0493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN00141267
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00141267
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: