DR. PATRICE DEIDRE CARRELLO (NPI# 1437215712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437215712 |
| Entity Type | Individual |
| Full Name | DR. PATRICE DEIDRE CARRELLO |
| Credential | PH.D. |
| Practice Address |
2354 Se 59th Ave Portland OR 97215-4018 |
| Practice Telephone | 5032323377 |
| Mailing Telephone | 5032323377 |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2009-06-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
1626 | OR | Behavioral Health & Social Service Providers |
| Street Address |
2354 SE 59TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97215-4018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477862142 | Psychmed LLC | Registered Nurse | 2354 Se 59th Ave, Portland, OR 97215-4018 | 2010-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952926339 | Lisa Silverman | Counselor | 1835 Se 50th Avenue, Portland, OR 97215 | 2020-06-11 |
| 1003381195 | Darcie Leigh Juarez | Naturopath | 6118 Se Belmont St Ste 407, Portland, OR 97215 | 2018-10-04 |
| 1740710581 | Riley W Protz | Pharmacist | 5544 E Bursnide, Portland, OR 97215 | 2017-06-14 |
| 1114459088 | Genevieve Kathleen Shields | Registered Nurse | 5451 Se Belmont, Suite 100, Portland, OR 97215 | 2017-03-30 |
| 1205282514 | Aiyana Lucas | Social Worker | 4531 Se Belmont St Ste 310b, Portland, OR 97215 | 2016-05-05 |
| 1508223918 | Catherine Ann Chapman | Counselor | 422 Se 79th Street, Suite 202, Portland, OR 97215 | 2016-01-15 |
| 1518338854 | Cody Begdorian | Acupuncturist | 4220 Se Stark, Portland, OR 97215 | 2015-10-13 |
| 1588040653 | Corinne Leblanc | Acupuncturist | 2305 Se 50th Ave., Suite 200, Portland, OR 97215 | 2015-07-30 |
| 1942688544 | Casey Lynne Peters | Occupational Therapist | 6040 Se Belmont S, Portland, OR 97215 | 2015-05-14 |
| 1457743783 | David Alexander Gambill | Counselor | 8041 E Burnside St., Portland, OR 97215 | 2015-02-24 |
| Find all providers in zip 97215 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861007387 | Lyle Vintinner | Psychologist | 53 Baxter Blvd Ste 3, Portland, ME 04101-1827 | 2020-09-11 |
| 1194341297 | Natalie Dawn Mitchell | Psychologist | 3762 Sw Council Crest Dr, Portland, OR 97239-1595 | 2020-06-24 |
| 1992331607 | Erin A. Mueller | Psychologist | 718 Sw Alder St Ste 200, Portland, OR 97205-3423 | 2020-03-14 |
| 1952940520 | Timothy Allen Cooper | Psychologist | 3331 Sw Hamilton Ct, Portland, OR 97239-1256 | 2019-12-31 |
| 1215574058 | Northwest Dbt LLC | Psychologist | 2230 Nw Pettygrove St., Suite 130, Portland, OR 97210 | 2019-11-27 |
| 1093373631 | Emily Catherine Stasko | Psychologist | 1950 Nw Raleigh St Apt 201, Portland, OR 97209-1775 | 2019-05-29 |
| 1174094544 | Juniper Psychological Services | Psychologist | 2827 Ne Alberta St, Portland, OR 97211-6350 | 2018-12-11 |
| 1528539335 | Mark G Kiefner Phd LLC | Psychologist | 225 Commercial St Ste 403, Portland, ME 04101-6603 | 2018-12-06 |
| 1467941831 | Shannon Madore | Psychologist | 3710 Sw Us Veterans Hospital Rd # R&d66, Portland, OR 97239-2964 | 2018-05-01 |
| 1033637202 | Kaylin Jones | Psychologist | 1235 Se Division Street, Suite 115, Portland, OR 97202-9720 | 2017-09-07 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on DR. PATRICE DEIDRE CARRELLO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.