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Organization
MARILYN J BOOTH MD
Active
Organization
MARILYN J BOOTH MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARILYN J BOOTH MD (OWNER)
(503) 357-7194
Entity
Organization
Contact information
Practice address
3305 19TH AVE, FOREST GROVE, OR 97116-1909
(503) 357-7194
(503) 357-5735
Mailing address
3305 19TH AVE, FOREST GROVE, OR 97116-1909
(503) 357-7194
(503) 357-5735
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD13329
OR
Other
Enumeration date
01/23/2007
Last updated
03/23/2008
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