Provider Demographics
NPI:1588091581
Name:GOODWORTH, MARIE-CHRISTINE RUTTER (PHD)
Entity type:Individual
Prefix:DR
First Name:MARIE-CHRISTINE
Middle Name:RUTTER
Last Name:GOODWORTH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 N MERIDIAN ST # V104
Mailing Address - Street 2:GEORGE FOX UNIVERSITY GRADUATE DPT OF CLINICAL PSYCH
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-2697
Mailing Address - Country:US
Mailing Address - Phone:503-554-2382
Mailing Address - Fax:
Practice Address - Street 1:414 N MERIDIAN ST # V104
Practice Address - Street 2:GEORGE FOX UNIVERSITY GRADUATE DPT OF CLINICAL PSYCH
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-2697
Practice Address - Country:US
Practice Address - Phone:503-554-2382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-04
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2178103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical