Search › Oregon › 101YM0800X
Jack Kelley, L.P.C
NPI 1265873343 · on the registry since 2013
Practice
- Address
- 1027 E Burnside St
Portland, OR 97214 - Phone
- (503) 239-8400
- Fax
- (503) 239-8406
- Organisation at this address
- Coda, Inc.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 71
Registry record
- Primary taxonomy
- 101YM0800X
101YM0800X
- Licence states on file
- OR
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2013-12-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon