Provider Demographics
NPI:1134095110
Name:TRUJILLO, ROBERT EUGENE
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:EUGENE
Last Name:TRUJILLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ROBERT
Other - Middle Name:TRUJILLO
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1369 THOMPSON RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURN
Mailing Address - State:OR
Mailing Address - Zip Code:97071-2616
Mailing Address - Country:US
Mailing Address - Phone:970-408-3803
Mailing Address - Fax:
Practice Address - Street 1:3160 CENTER ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4530
Practice Address - Country:US
Practice Address - Phone:971-900-9803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist