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NPI 1588305288

NPI 1588305288 : MADELINE JULIETTE BOYLE DPM : LAKE STEVENS, WA

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General NPI Number Information
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    NPI Number           |    1588305288
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    Entity Type          |    Individual 
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    Provider Name        |    MADELINE JULIETTE BOYLE DPM
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/05/2022
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    Last Update Date     |    07/08/2025
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Provider Practice Location Address
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    Address Line         |    9514 4TH ST NE UNIT 201 
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    City                 |    LAKE STEVENS
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    State                |    WA
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    Zip                  |    98258-1937
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    Country              |    US
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    Telephone            |    425-397-7401
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    Fax                  |    425-397-7627
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Provider Business Mailing Address
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    Address Line         |    1364 CLIFTON RD NE 
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    City                 |    ATLANTA
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    State                |    GA
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    Zip                  |    30322-1059
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    213ES0103X
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    Taxonomy Name        |    Foot & Ankle Surgery Podiatrist
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    License Number       |    PO61672188
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    License Number State |    WA
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