Healthcare Provider Details

I. General information

NPI: 1366363913
Provider Name (Legal Business Name): KERI FRANCIS KENNEDY
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10117 MAIN ST
BOTHELL WA
98011-3425
US

IV. Provider business mailing address

15820 56TH AVE W
EDMONDS WA
98026-4627
US

V. Phone/Fax

Practice location:
  • Phone: 425-806-5525
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: