Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Carl Wallace Leder, PA-C

Individual provider Physician Assistant · NPI 1619341724

Carl Wallace Leder, PA-C is a Physician Assistant in Roseburg, Oregon. Licensed in Oregon. Registered with an NPI since 2015.

Licensed in
OR
In the registry since
2015
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

621 W Madrone St
Roseburg, OR 97470-3090
Phone: (541) 672-2691
Fax: (833) 299-8415
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA174113 (OR)

Record details

NPI number1619341724
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 1, 2015
Last updated in NPPESFebruary 23, 2022
Certification dateFebruary 23, 2022

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