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Contact Information

JACOB H NELSON, DO
3303 S BOND AVE
PORTLAND, OR97239-4501
 Phone: 360-831-3123
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for JACOB H NELSON · (Male)

NPI # 1568920882
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 03/05/2019
Last updated 03/13/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • OR License # DO212889
  • VA License # 0116035953
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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