Individual provider · Type 1 NPI

Jacob Kelly Smith, MD

Student in an Organized Health Care Education/Training Program · Portland, OR

NPI number 1508457300 Active

Practice location

9205 SW Barnes Rd
Portland, OR 97225-6603

Call (503) 216-2621 Map

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other practice locations

  • 3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011 · (503) 860-3996

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XPG215454 (OR)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1508457300

Jacob Kelly Smith, MD's National Provider Identifier is 1508457300, issued on Feb 3, 2021. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Portland, OR. The record was last updated on Jun 18, 2023.