Provider Demographics
NPI:1851830871
Name:BOYCE, MADISON
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:BOYCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-4328
Mailing Address - Country:US
Mailing Address - Phone:252-496-3624
Mailing Address - Fax:425-212-4201
Practice Address - Street 1:1720 GROVE ST
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-4328
Practice Address - Country:US
Practice Address - Phone:252-496-3624
Practice Address - Fax:360-658-2522
Is Sole Proprietor?:No
Enumeration Date:2017-02-23
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
WAMC60695352101Y00000X
WALH60938810101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor