Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacob Kelly Smith, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1508457300

Jacob Kelly Smith, MD is a Student in an Organized Health Care Education/Training Program in Portland, Oregon. Works from 2 locations. Licensed in Oregon.

Licensed in
OR
In the registry since
2021
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

9205 SW Barnes Rd
Portland, OR 97225-6603
Phone: (503) 216-2621
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

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

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X · Licence PG215454 (OR)

Record details

NPI number1508457300
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 3, 2021
Last updated in NPPESJune 18, 2023
Certification dateJune 18, 2023

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