Provider Demographics
NPI:1174906762
Name:TRUJILLO, TRISHA (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2219 MARTIN AVE E
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-8215
Mailing Address - Country:US
Mailing Address - Phone:360-979-9230
Mailing Address - Fax:
Practice Address - Street 1:425 MITCHELL AVE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-4114
Practice Address - Country:US
Practice Address - Phone:360-874-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-01
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60554371225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist