Provider Demographics
NPI:1700257631
Name:PUULEI-PALAUNI, TRUDY LEILANI
Entity type:Individual
Prefix:
First Name:TRUDY
Middle Name:LEILANI
Last Name:PUULEI-PALAUNI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9040 REID STREET,
Mailing Address - Street 2:ATTN: MCHJ-CLQ-C MADIGAN ARMY MEDICAL CENTER
Mailing Address - City:TACOMA,
Mailing Address - State:WA
Mailing Address - Zip Code:98431-1000
Mailing Address - Country:US
Mailing Address - Phone:253-968-1110
Mailing Address - Fax:877-874-1031
Practice Address - Street 1:9040 REID STREET,
Practice Address - Street 2:ATTN: MCHJ-CLQ-C MADIGAN ARMY MEDICAL CENTER
Practice Address - City:TACOMA,
Practice Address - State:WA
Practice Address - Zip Code:98431-1000
Practice Address - Country:US
Practice Address - Phone:253-968-1110
Practice Address - Fax:877-874-1031
Is Sole Proprietor?:No
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60468689376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide