Jacob Kelly Smith, MD - Portland, OR

Jacob Kelly Smith, MD

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

NPI 1508457300

Jacob Kelly Smith is a Student in an Organized Health Care Education/Training Program based in Portland, OR. Jacob Kelly Smith practices in Portland, OR and has the professional credentials of MD. The NPI Number for Jacob Kelly Smith is 1508457300 and holds a License No. PG215454 (Oregon).

The current practice location address for Jacob Kelly Smith is 9205 Sw Barnes Rd, Portland, OR and can be reached out via phone at 503-216-2621.

Location: 9205 Sw Barnes Rd, Portland, OR, 97208-3158

NPI Number

1508457300

Provider Name

Jacob Kelly Smith

Credential

Provider Entity Type

Individual

Gender

Male

Address

9205 Sw Barnes Rd, Portland, OR, 97208-3158

Phone Number

503-216-2621

Fax Number

Provider Enumeration Date

02/03/2021

Last Update Date

03/10/2024

Address

9205 Sw Barnes Rd

City

Portland

State

Oregon

Zip

97225-6603

Phone Number

503-216-2621

Fax Number

Address

9205 Sw Barnes Rd

City

Portland

State

Oregon

Zip

97225-6603

Phone Number

503-216-2621

Fax Number

Type

Student, Health Care

Classification

Student in an Organized Health Care Education/Training Program

Speciality

Taxonomy

390200000X

License No.

PG215454 (Oregon)

Definition

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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