Dr Michael Leidecker, PSYD is a
Student In An Organized Health Care Education/training Program based in Portland, Oregon. Dr Michael Leidecker is licensed to practice in NU (license number ) and his current practice location is
2222 Nw Lovejoy St Ste 406, Portland, Oregon. He can be reached at his office (for appointments etc.) via phone at
(503) 975-0101.
NPI number for Dr Michael Leidecker is 1689976425 and his current mailing address is 2222 Nw Lovejoy St Ste 406, Portland, Oregon. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1689976425.
Healthcare Provider's Profile
| Full Name | Dr Michael Leidecker |
|---|
| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 2222 Nw Lovejoy St Ste 406, Portland, Oregon |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1689976425
- Provider Enumeration Date: 11/30/2010
- Last Update Date: 08/18/2026
Medical Identifiers
Medical identifiers for Dr Michael Leidecker such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1689976425 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | (NU) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (NU) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Michael Leidecker is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Michael Leidecker, PSYD
2222 Nw Lovejoy St Ste 406,
Portland, OR 97210-5108
Ph: (503) 975-0101 | Dr Michael Leidecker, PSYD
2222 Nw Lovejoy St Ste 406,
Portland, OR 97210-5108
Ph: (503) 975-0101 |
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