Jacqueline D Lebrun, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

20617 Issued in OR

Practice address

8495 Crater Lake Hwy
White City, OR 97503-3011

Phone

(541) 830-7593

NPI assigned

Aug 20, 2008

Sex

Female

Sole proprietor

No

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)

Enrolled

State licenses

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1912154089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 NE MARY ROSE PL",
            "address_2": "STE 120",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017132",
            "telephone_number": "541-382-6799",
            "fax_number": "541-312-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8495 CRATER LAKE HWY",
            "city": "WHITE CITY",
            "state": "OR",
            "postal_code": "975033011",
            "telephone_number": "541-830-7593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBRUN",
        "first_name": "JACQUELINE",
        "middle_name": "D",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-20",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "OR",
            "license": "20617",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OR",
            "license": "20617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Audiologist in White City, OR
• Providers in White City, OR by specialty
• Audiologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; 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.