Healthcare Provider Details

I. General information

NPI: 1184519613
Provider Name (Legal Business Name): JENNIFER KLINE SHERNOFF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1839 N 57TH ST
SEATTLE WA
98103-5912
US

IV. Provider business mailing address

1839 N 57TH ST
SEATTLE WA
98103-5912
US

V. Phone/Fax

Practice location:
  • Phone: 206-790-0607
  • Fax:
Mailing address:
  • Phone: 206-790-0607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFTA.MG.70116980
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: