MEDICARE: JENNIFER ROESSLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFT.LF.70021004	WA

General Provider Information

NPI Number	:	1326760042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ROESSLER

Provider Business Mailing Address
First Line	:	3950 N LAKE SHORE DR # 1001A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-3434
Country	:	US
Telephone Number	:	510-858-9810
Fax Number	:

Provider Business Practice Location Address
First Line	:	4512 6TH AVE NW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-4420
Country	:	US
Telephone Number	:	510-858-9810
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2022
Last Update Date	:	12/17/2025

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Directions to “ JENNIFER ROESSLER ” Practice Location

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