Provider Demographics
NPI:1811872542
Name:SCHUNKE, JACOB AUSTIN
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:AUSTIN
Last Name:SCHUNKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20520 LYSANDER PL
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-7068
Mailing Address - Country:US
Mailing Address - Phone:458-287-0553
Mailing Address - Fax:
Practice Address - Street 1:389 SW SCALEHOUSE CT
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3241
Practice Address - Country:US
Practice Address - Phone:541-306-4446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist