Individual
DR. MICHAEL LEIDECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
516 SE MORRISON ST, SUITE #1010, PORTLAND, OR 97214-2327
(503) 292-2661
Mailing address
516 SE MORRISON ST, SUITE #1010, PORTLAND, OR 97214-2327
(503) 975-0101
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/30/2010
Last updated
07/24/2012
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