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Individual

MARCIA SUE CHENOWETH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
200 E 22ND ST, SUITE A, VANCOUVER, WA 98663-3266
(360) 696-2744
(360) 696-4811
Mailing address
200 E 22ND ST, SUITE A, VANCOUVER, WA 98663-3266
(360) 696-2744
(360) 696-4811

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY00003694
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0007701286
AETNA
CT
01
060002290CT04
ANTHEM BLUE CROSS
CT
01
2072865
CIGNA BEHAVIORAL
CT
01
213058
COMPSYCH
CT
01
242213
MHN
CT
01
61-49786
UNITED BEHAVIORAL HEALTH
CT
Enumeration date
07/11/2006
Last updated
12/07/2007
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