Dr. Patrice Deidre Carrello, PH.D.
Psychologist, Clinical in Portland, OR. Individual provider (NPI-1).
NPI number1437215712
StatusActive
Last updated in NPPESJul 28, 2026
Details
- NPI
- 1437215712
- Entity type
- Individual (NPI-1)
- Name
- Dr. Patrice Deidre Carrello
- Credential
- PH.D.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 29, 2006
- Certification date
- Jul 28, 2026
- Last updated
- Jul 28, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 1626 | OR | Yes |
| 103G00000X | Clinical Neuropsychologist | – | – |
Practice location
2100 Ne Broadway St Ste 323Portland, OR 97232-1570
Phone 541-500-8655
Mailing address
2354 Se 59th AvePortland, OR 97215-4018
Phone 541-500-8655
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