Healthcare Provider Details

I. General information

NPI: 1528679529
Provider Name (Legal Business Name): ALEAH JO TRUJILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALEAH BENNETT

II. Dates (important events)

Enumeration Date: 08/12/2020
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 3RD AVE
SEATTLE WA
98104-2304
US

IV. Provider business mailing address

7919 21ST AVE E
TACOMA WA
98404-4159
US

V. Phone/Fax

Practice location:
  • Phone: 206-464-1570
  • Fax:
Mailing address:
  • Phone: 218-244-4044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: