Provider Demographics
NPI:1669984282
Name:TRUDEAU, MEGHAN (PA-C)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:TRUDEAU
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:
Other - Last Name:BRAICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3002 BONSHAW CT SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-6658
Mailing Address - Country:US
Mailing Address - Phone:408-839-9014
Mailing Address - Fax:
Practice Address - Street 1:1414 S 324TH ST STE B207
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8444
Practice Address - Country:US
Practice Address - Phone:253-220-3121
Practice Address - Fax:415-252-7176
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-05
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
WAPA.PA.61241251363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant