Healthcare Provider Details

I. General information

NPI: 1710700612
Provider Name (Legal Business Name): JENNA MARIE TRUMBULL M.ED, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2024
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7024 27TH ST W STE B
UNIVERSITY PLACE WA
98466-5216
US

IV. Provider business mailing address

4513 S 7TH ST
TACOMA WA
98405-1204
US

V. Phone/Fax

Practice location:
  • Phone: 253-888-9699
  • Fax:
Mailing address:
  • Phone: 253-888-9699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number61622766
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number526033F
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: