JACOB MAUCK (NPI# 1760903603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760903603 |
| Entity Type | Individual |
| Full Name | JACOB MAUCK |
| Credential | M.S. CF-SLP |
| Practice Address |
350 S 8th St Lebanon OR 97355-2242 |
| Mailing Address |
2705 Nw Garryanna Dr Apt 3 Corvallis OR 97330-1389 |
| Practice Telephone | 5412591221 |
| Mailing Telephone | 5414350394 |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2017-06-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 016041 | OR | Speech, Language and Hearing Service Providers |
| Street Address |
350 S 8TH ST |
| City | LEBANON |
| State | OR |
| Zip Code | 97355-2242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962001172 | Kaycie Linn Blanshan | Occupational Therapy Assistant | 350 S 8th St, Lebanon, OR 97355-2242 | 2020-10-19 |
| 1104476969 | Cody Cataldo-gillman | Physical Therapist | 350 S 8th St, Lebanon, OR 97355-2242 | 2019-09-13 |
| 1891267282 | Alexandria Nelson | Occupational Therapy Assistant | 350 S 8th St, Lebanon, OR 97355-2242 | 2018-12-22 |
| 1528589942 | Kayela Ann Gatchet | Occupational Therapy Assistant | 350 S 8th St, Lebanon, OR 97355-2242 | 2017-07-06 |
| 1245782184 | Suzanne Eklund | Speech-Language Pathologist | 350 S 8th St, Lebanon, OR 97355-2242 | 2016-10-26 |
| 1649659947 | Anna Elizabeth Slade | Physical Therapist | 350 S 8th St, Lebanon, OR 97355-2242 | 2015-05-20 |
| 1942636642 | Timothy Scott | Speech-Language Pathologist | 350 S 8th St, Lebanon, OR 97355-2242 | 2013-09-25 |
| 1891137956 | Brian Christopher Allsopp | Physical Therapist | 350 S 8th St, Lebanon, OR 97355-2242 | 2013-07-18 |
| 1356781405 | Renee Diener | Occupational Therapist | 350 S 8th St, Lebanon, OR 97355-2242 | 2013-07-02 |
| 1376880773 | Enffie Chen | Occupational Therapist | 350 S 8th St, Lebanon, OR 97355-2242 | 2013-01-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710516182 | Patricia Hoangphuong Nguyen | Student in an Organized Health Care Education/Training Program | Western University of Health Sciences Comp-northwest, 200 Mullins Drive, Lebanon, OR 97355 | 2020-04-07 |
| 1528609740 | Liana Beaty | Technician | 31231 Mccraven Ln, Lebanon, OR 97355 | 2019-09-30 |
| 1710465323 | Jackie Welter | Health Educator | 35 Mullins Drvie Ste 3, Lebanon, OR 97355 | 2018-08-06 |
| 1518415371 | Kathleen Hillary | Registered Nurse | 525 North Santiam Highway, Lebanon, OR 97355 | 2016-09-21 |
| 1861849283 | Emily Marshall | Student in an Organized Health Care Education/Training Program | 200 Mullins Drive, Lebanon, OR 97355 | 2016-05-16 |
| 1033565551 | Celeste Maxine Croy-baker | Student in an Organized Health Care Education/Training Program | 200 Mullins Dr., Lebanon, OR 97355 | 2016-05-13 |
| 1770956963 | Jeff Parsons | Occupational Therapist | 600 Ne 5th St, Oregon Veterans Home, Lebanon, OR 97355 | 2015-11-10 |
| 1003289588 | Hong Ngoc Nguyen | Pharmacist | 675 N Fifth Street, Lebanon, OR 97355 | 2015-11-05 |
| 1801278049 | Darrel A Decker | Skilled Nursing Facility | 350 8th Street, Lebanon, OR 97355 | 2015-06-24 |
| 1679985113 | State of Oregon Department of Veterans' Affairs | Skilled Nursing Facility | 600 N. 5th Street, Lebanon, OR 97355 | 2014-06-02 |
| Find all providers in zip 97355 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942815048 | Francesca Pendolino | Speech-Language Pathologist | 3 Moulton Ave, Lebanon, NH 03766-1852 | 2020-09-15 |
| 1699396184 | Heather Souza | Speech-Language Pathologist | 193 Hanover St, Lebanon, NH 03766-1090 | 2020-05-06 |
| 1174163943 | Angela Jeanne Cole | Speech-Language Pathologist | 1272 Weathervane Way, Lebanon, OH 45036-7741 | 2020-01-09 |
| 1568011690 | Ann Dorazio | Speech-Language Pathologist | 116 Scenic Ridge Blvd, Lebanon, PA 17042-5818 | 2019-09-11 |
| 1033762356 | Abigail Zurliene | Speech-Language Pathologist | 10937 Sylvan Vista Dr, Lebanon, IL 62254-2334 | 2019-07-17 |
| 1689155988 | Sarah Smith | Speech-Language Pathologist | 533 Indian Creek Rd, Lebanon, KY 40033-1962 | 2018-08-24 |
| 1407336589 | Ashley Cheney | Speech-Language Pathologist | 224 Commercial Street, Lebanon, MO 65536-3260 | 2018-08-17 |
| 1457867202 | Elizabeth Altizer Baker | Speech-Language Pathologist | 84 Lorraine C. Turner Dr., Russell County Public Schools, Lebanon, VA 24266 | 2017-12-15 |
| 1851805683 | Laura Hankins Vencill | Speech-Language Pathologist | Russell County Public Schools, 84 Lorraine C. Turner Dr., Lebanon, VA 24266 | 2017-12-01 |
| 1306359633 | Jill Lynn Groom | Speech-Language Pathologist | 1417 Ogles Creek Ct, Lebanon, IL 62254-1834 | 2017-11-08 |
| Find all providers in LEBANON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.