Provider Demographics
NPI:1235228099
Name:CARTER, LESLIE ELIZABETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:ELIZABETH
Last Name:CARTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 SW OAK ST
Mailing Address - Street 2:STE 325
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-6588
Mailing Address - Country:US
Mailing Address - Phone:503-807-7413
Mailing Address - Fax:503-935-5884
Practice Address - Street 1:9600 SW OAK ST
Practice Address - Street 2:STE 325
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-6588
Practice Address - Country:US
Practice Address - Phone:503-807-7413
Practice Address - Fax:503-935-5884
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1386103TM1800X, 103TR0400X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation