Organization
LELAND ST. CHARLES, PSYCHOLOGIST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LELAND ST CHARLES PSYD (PSYCHOLOGIST, OWNER, SOLE MEMBER)
(503) 755-8808
Entity
Organization
Contact information
Practice address
1210 SE OAK ST, PORTLAND, OR 97214-1427
(503) 755-8808
(971) 339-8595
Mailing address
8415 SE 75TH AVE, PORTLAND, OR 97206-8613
(415) 710-6141
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/25/2022
Last updated
01/07/2023
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