Marilyn J Booth MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD13329 Issued in OR

Legal business name

MARILYN J BOOTH MD

Practice address

3305 19TH Ave
Forest Grove, OR 97116-1909

Phone

(503) 357-7194

Fax

(503) 357-5735

NPI assigned

Jan 23, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marilyn J Booth, MD

Title

Owner

Phone

(503) 357-7194

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Janice A Tsuchida, FNP

  • Family Nurse Practitioner
  • Forest Grove, OR
  • NPI 1124188198
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206230400000",
    "number": "1265586317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 19TH AVE",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161909",
            "telephone_number": "503-357-7194",
            "fax_number": "503-357-5735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 19TH AVE",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161909",
            "telephone_number": "503-357-7194",
            "fax_number": "503-357-5735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARILYN J BOOTH MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2008-03-23",
        "status": "A",
        "authorized_official_last_name": "BOOTH",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-357-7194",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD13329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26676-7",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Managed Health Care of Oregon I LLC (Managed Healthcare of Or LLC)
• Cristina Leigh Mandera, LMT
• Maple Street Clinic Pharmacy LLC (Maple Street Clinic Pharmacy)
• Maple Street Clinic, PC
• Noah Marek, PT
• Marquis Companies II, Inc (Marquis Forest Grove Assisted Living)
• Marquis Companies II, Inc. (Marquis Forest Grove Post Acute Rehab)
• Jennifer Renae Martens, DC, LMT
• Alma Rae Mattocks, ATC
• Deborah Maurseth, DPT

• Family Medicine Physician in Forest Grove, OR
• Providers in Forest Grove, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.