Provider Demographics
NPI:1912751363
Name:HIJIKATA, RYU ERIC
Entity type:Individual
Prefix:MR
First Name:RYU
Middle Name:ERIC
Last Name:HIJIKATA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19426 SE 128TH ST
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98059-8739
Mailing Address - Country:US
Mailing Address - Phone:949-878-7883
Mailing Address - Fax:
Practice Address - Street 1:621 PACIFIC AVE STE 300
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-4611
Practice Address - Country:US
Practice Address - Phone:949-878-7883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist