Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Jack De Boer, CCC-A

Individual provider Audiologist · NPI 1750535373

Mr. Jack De Boer, CCC-A is an Audiologist in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2008.

Licensed in
MI
In the registry since
2008
Specialties on file
3
What do these letters mean?
CCC-A — Certificate of Clinical Competence in Audiology
An audiologist certified by ASHA.

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Practice location Address checks out

2036 Chesaning Dr SE
Grand Rapids, MI 49506-5309
Phone: (616) 819-3070
Fax: (616) 819-3239
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Audiologist (primary) Taxonomy 231H00000X · Licence 1601000343 (MI)
Assistive Technology Practitioner Audiologist Taxonomy 231HA2400X · Licence 1601000342 (MI)
Audiologist-Hearing Aid Fitter Taxonomy 237600000X · Licence 1601000343 (MI)

Record details

NPI number1750535373
Entity typeIndividual (Type 1)
GenderMale
Credentials CCC-A
Sole proprietorNo
NPI enumeratedNovember 10, 2008
Last updated in NPPESNovember 10, 2008

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