Alyssa Charboneau, RN, IBCLC, CLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

L-315382 Issued in OR

Practice address

1361 Modoc St
Springfield, OR 97477-4124

Phone

(541) 206-7970

NPI assigned

Jul 23, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1780412593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 MODOC ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774124",
            "telephone_number": "541-206-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 MODOC ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774124",
            "telephone_number": "541-206-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARBONEAU",
        "first_name": "ALYSSA",
        "credential": "RN, IBCLC, CLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-23",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "OR",
            "license": "201800176RN",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "OR",
            "license": "L-315382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Lane Chandler, M.S., Q.M.H.P.
• Katlynn Brianne Chaney
• Ya-Ling Chang, M.ED.
• Leah Mae Chapman, MA
• Jay H Chappell, M.D.
• Matthew David Charlton, PA
• Talesa Marie Chartrand, PHD, STUDENT DOCTOR
• Alissa Nicole Chase
• Celina Chauvin
• Paul A Chavin, MD

• Lactation Consultant (Registered Nurse) in Springfield, OR
• Providers in Springfield, OR by specialty
• Lactation Consultant (Registered Nurse) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.