Individual
DR. ROGER DAVID CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1838 SW JEFFERSON ST, PORTLAND, OR 97201-2463
(503) 245-2929
(503) 245-4478
Mailing address
9450 SW 52ND AVE, PORTLAND, OR 97219-5040
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1511
OR
Other
Enumeration date
04/22/2007
Last updated
10/11/2018
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