Provider Demographics
NPI:1851504104
Name:BOYLE, WILLIAM S (MA, CDP, ICADC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:S
Last Name:BOYLE
Suffix:
Gender:M
Credentials:MA, CDP, ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2527 87TH AVE. W., #136
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466
Mailing Address - Country:US
Mailing Address - Phone:253-473-7474
Mailing Address - Fax:
Practice Address - Street 1:5915 ORCHARD ST W BLDG B
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98467-3824
Practice Address - Country:US
Practice Address - Phone:253-473-7474
Practice Address - Fax:253-474-9724
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00004939101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)