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Individual

DR. PATRICE DEIDRE CARRELLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
2354 SE 59TH AVE, PORTLAND, OR 97215-4018
(541) 500-8655
Mailing address
2354 SE 59TH AVE, PORTLAND, OR 97215-4018
(541) 500-8655

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
103TC0700X
Clinical Psychologist
Primary
1626
OR

Other

Enumeration date
12/29/2006
Last updated
06/03/2025
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