=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235083767
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STORMY GAIL TRUJILLO LMT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/23/2026
-----------------------------------------------------
Last Update Date | 02/23/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19856 SE HIGHWAY 212
-----------------------------------------------------
City | DAMASCUS
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97089-5743
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-855-4124
-----------------------------------------------------
Fax | 503-386-2745
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19856 SE HIGHWAY 212
-----------------------------------------------------
City | DAMASCUS
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97089-5743
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-855-4124
-----------------------------------------------------
Fax | 503-386-2745
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | 29442
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------