Provider Demographics
NPI:1912116013
Name:CHENOWETH, JOHN BARROWS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BARROWS
Last Name:CHENOWETH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:B
Other - Last Name:CHENOWETH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5410 S.W. MACADAM AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3825
Mailing Address - Country:US
Mailing Address - Phone:503-222-0773
Mailing Address - Fax:503-222-2568
Practice Address - Street 1:5410 S.W. MACADAM AVE
Practice Address - Street 2:STE 200
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3825
Practice Address - Country:US
Practice Address - Phone:503-222-0773
Practice Address - Fax:503-222-2568
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD244952084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry