| Doctor Name: | MATTHEW RYAN BOOTH |
| NPI Number: | 1265416291 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 3968 |
| Business Practice Address: | 415 E Parkcenter Blvd Suite 114 Boise, ID - 837066504 |
| Business Phone Number: | 2084339211 |
| Business Fax Number: | 2084339241 |
| Mailing Address: | 16083 Sw Upper Boones Ferry Rd, Suite 300 TIGARD |
| State: | OR |
| Postal Code: | 972247736 |
| Phone Number: | 8002198835 |
| Fax Number: | 5036399699 |
| NPI Enumeration Date: | 12/02/2005 |
| NPI Last Update Date: | 10/09/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 3968 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |