Healthcare Provider Details

I. General information

NPI: 1801095997
Provider Name (Legal Business Name): DANIEL SCOTT CHENOWETH PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 NE 2ND AVE
PORTLAND OR
97232-2043
US

IV. Provider business mailing address

1121 NE 2ND AVE
PORTLAND OR
97232-2043
US

V. Phone/Fax

Practice location:
  • Phone: 503-731-8656
  • Fax:
Mailing address:
  • Phone: 503-731-8656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2423
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: