Jacob Mauck, M.S. CF-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

016041 Issued in OR

Practice address

350 S 8TH St
Lebanon, OR 97355-2242

Phone

(541) 259-1221

NPI assigned

Jun 30, 2017

Last updated

Jun 30, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498780800000",
    "number": "1760903603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 NW GARRYANNA DR APT 3",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973301389",
            "telephone_number": "541-435-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S 8TH ST",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973552242",
            "telephone_number": "541-259-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUCK",
        "first_name": "JACOB",
        "credential": "M.S. CF-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-30",
        "last_updated": "2017-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "016041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Rae Masog, BS,CADC1
• Dina Mason, DO
• Samuel Aaron Matheny
• Leeda Merin Mathew, DO
• Evangaline Matley
• Natalie Jane Maughan, PA
• Anna Mayfield
• D. Timothy McCarley, M.D.
• Leigh McCarthy
• Dillon McDonald

• Speech-Language Pathologist in Lebanon, OR
• Providers in Lebanon, OR by specialty
• Speech-Language Pathologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.