Healthcare Provider Details

I. General information

NPI: 1114848603
Provider Name (Legal Business Name): JACQUELINE FLANNERY MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10005 24TH ST E
EDGEWOOD WA
98371-2130
US

IV. Provider business mailing address

1018 E SHELBY ST
SEATTLE WA
98102-3821
US

V. Phone/Fax

Practice location:
  • Phone: 253-533-3248
  • Fax: 253-952-2698
Mailing address:
  • Phone: 206-747-1734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: