Individual
DR. KENNETH ALLAN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-2200
Mailing address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-2200
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD22997
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287590
—
OR
Enumeration date
09/20/2006
Last updated
08/29/2025
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