Provider Demographics
NPI:1619461415
Name:CHENEY, CODY AMMON (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CODY
Middle Name:AMMON
Last Name:CHENEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W UNIVERSITY PKWY
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-6703
Mailing Address - Country:US
Mailing Address - Phone:801-863-8876
Mailing Address - Fax:801-863-7056
Practice Address - Street 1:10011 SE DIVISION ST STE 203
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-1354
Practice Address - Country:US
Practice Address - Phone:503-255-2343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling