| Doctor Name: | MARILYN J BOOTH |
| NPI Number: | 1225057011 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | MD13329 |
| Business Practice Address: | 3305 19th Ave Forest Grove, OR - 971161909 |
| Business Phone Number: | 5033577194 |
| Business Fax Number: | 5033575735 |
| Mailing Address: | 3305 19th Ave, FOREST GROVE |
| State: | OR |
| Postal Code: | 971161909 |
| Phone Number: | 5033577194 |
| Fax Number: | 5033575735 |
| NPI Enumeration Date: | 07/19/2006 |
| NPI Last Update Date: | 02/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VX0000X |
| License Number: | MD13329 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Obstetrics |
| Taxonomy Definition: | |