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General NPI Number Information
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NPI Number | 1063180446
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Entity Type | Individual
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Provider Name | JACOB LIM SCHEEL DDS
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Gender | Male
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Dates
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Enumeration Date | 09/01/2021
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 6400 SE LAKE RD STE 140
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City | PORTLAND
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State | OR
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Zip | 97222-2194
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Country | US
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Telephone | 503-496-4766
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Fax |
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Provider Business Mailing Address
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Address Line | 6400 SE LAKE RD STE 140
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City | PORTLAND
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State | OR
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Zip | 97222-2194
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Country | US
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Telephone | 503-496-4766
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 30.027455
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 37759
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | D12204
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License Number State | OR
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