Organization
LELAND ST. CHARLES, PSYCHOLOGIST, LLC
Active
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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