MEDICARE: SARAH JO POND IBCLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174N00000X	Lactation Consultant (Non-RN)	L-320661	OR

General Provider Information

NPI Number	:	1265381545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH JO POND IBCLC

Provider Business Mailing Address
First Line	:	1159 SW 11TH ST
Second Line	:
City	:	NEWPORT
State	:	OR
Zip	:	97365-5206
Country	:	US
Telephone Number	:	508-380-2930
Fax Number	:

Provider Business Practice Location Address
First Line	:	1955 MURPHY AVE
Second Line	:
City	:	CRESCENT CITY
State	:	CA
Zip	:	95531-8606
Country	:	US
Telephone Number	:	508-380-2930
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2026
Last Update Date	:	01/28/2026

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Directions to “ SARAH JO POND IBCLC” Practice Location

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