Individual provider Active NPI

Keary Jenks, LMFT

  • Marriage & Family Therapist
  • Shoreline, WA
National Provider Identifier
1235637802
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LF70097181 Issued in WA
Practice address
17018 15TH Ave NE
Shoreline, WA 98155-5137
Phone
(206) 362-7282
NPI assigned
Jan 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LF70097181 WA Primary

Addresses

Primary practice location

17018 15TH Ave NE
Shoreline, WA 98155-5137

Mailing address

17018 15TH Ave NE
Shoreline, WA 98155-5137
Phone (206) 362-7282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240110002432 MN Practitioner - Marriage and Family Therapist 3274984661 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LF70097181WAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fraser Child and Family Center CurrentSince Jan 1, 2024 Accepting new patients
Fraser Past Accepting new patients

Locations

6458 City West Pkwy
Eden Prairie, MN 55344
Phone (952) 767-5900

9120 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 231-2590

2400 W 64th St
Richfield, MN 55423
Phone (612) 767-5166

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778112000000",
    "number": "1235637802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17018 15TH AVE NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981555137",
            "telephone_number": "206-362-7282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17018 15TH AVE NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981555137",
            "telephone_number": "206-362-7282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKS",
        "first_name": "KEARY",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-29",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF70097181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

Verify at the official NPI Registry.