Individual
RYAN LEIDERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2000 NE 42ND AVE PMB 1155, PORTLAND, OR 97213
(778) 875-1436
Mailing address
2000 NE 42ND AVE PMB 1155, PORTLAND, OR 97213
(778) 875-1436
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C7720
OR
101YP2500X
Professional Counselor
Primary
C7720
OR
Other
Enumeration date
05/11/2011
Last updated
04/09/2026
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