1. Home
  2. Directory
  3. Oregon
  4. Portland
  5. Counselor
  6. NPI Profile

MR. JACK DOUGLAS KELLEY L.P.C.
NPI 1265873343
Counselor - Mental Health in Portland, OR

Active since July 17, 2013
1027 E BURNSIDE ST, PORTLAND, OR 97214(503) 239-8400(503) 239-8406 Get Directions Write a Review

NPPES record last updated: December 17, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Jack Douglas Kelley L.p.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JACK DOUGLAS KELLEY L.P.C. (NPI 1265873343) is an individual mental health provider in Portland, Oregon, licensed in Oregon (C3282) and active in the NPI registry since July 2013.

NPPES Registry Identity

NPI1265873343
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMR. JACK DOUGLAS KELLEYCredential: L.P.C.
Location Address1027 E BURNSIDE STPortland, OR 97214-1328
Mailing Address1027 E Burnside StPortland, OR 97214-1328 · (503) 239-8400 · Fax (503) 239-8406
Phone(503) 239-8400
Fax(503) 239-8406
Sole ProprietorNo
Enumeration DateJuly 17, 2013
Last NPPES UpdateDecember 17, 2013
✔ NPI 1265873343 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in OR · C3282
1027 E BURNSIDE ST, Portland, OR 97214
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. LISA DIANE WATTS DO
Family Medicine
1027 E BURNSIDE ST
PORTLAND, OR 97214
Multnomah County (503) 239-8400
JENNA M CHANTARA MSW, CADCII, QMHP
Counselor (Addiction (Substance Use Disorder))
1027 E BURNSIDE ST
PORTLAND, OR 97214
Multnomah County (503) 239-8400
DR. JEFFREY BENTON HAYES MD
Family Medicine (Addiction Medicine)
1027 E BURNSIDE ST
PORTLAND, OR 97214
Multnomah County (503) 239-8400
MELINDA TAFT
Counselor
1027 E BURNSIDE ST
PORTLAND, OR 97214
Multnomah County (503) 239-8400
DR. THOMAS TURNER MEYER M.D.
Psychiatry & Neurology (Psychiatry)
1027 E BURNSIDE ST
PORTLAND, OR 97214
Multnomah County (503) 239-8400
BROOKE E JOHNSON
Counselor (Mental Health)
1027 E BURNSIDE ST
PORTLAND, OR 97214
Multnomah County (971) 202-8400
LINDSEY K NEELY
Counselor (Addiction (Substance Use Disorder))
1027 E BURNSIDE ST
PORTLAND, OR 97214
Multnomah County (503) 239-8400
MISS KARA EDGE MSW
Social Worker (Clinical)
1027 E BURNSIDE ST
PORTLAND, OR 97214
Multnomah County (503) 239-8400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Kelley's NPI number?

The NPI number for Jack Kelley is 1265873343. It was assigned to this individual provider in the NPPES registry on July 17, 2013.

Where is Jack Kelley located?

Jack Kelley practices at 1027 E Burnside St, Portland, OR 97214. The listed phone number is (503) 239-8400.

What is Jack Kelley's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Jack Kelley was last updated on December 17, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.