MEDICARE: MARSHA ALEXIS CHENOWETH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MD 60476301	WA
2	2084P0804X	Child & Adolescent Psychiatry Physician	MD 60476301	WA
3	2084P0800X	Psychiatry Physician	MD 60476301	WA

General Provider Information

NPI Number	:	1447478938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARSHA ALEXIS CHENOWETH M.D.

Provider Business Mailing Address
First Line	:	40 LAKE BELLEVUE DR STE 100
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98005-2480
Country	:	US
Telephone Number	:	425-209-0006
Fax Number	:	425-490-7551

Provider Business Practice Location Address
First Line	:	40 LAKE BELLEVUE DR STE 100
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98005-2480
Country	:	US
Telephone Number	:	425-209-0006
Fax Number	:	425-490-7551

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	05/28/2026

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