Shari Syrdal Jaques, ARNP MN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP30004096 Issued in WA

Practice address

17440 Brookside Blvd NE
Lake Forest Park, WA 98155

Phone

(206) 366-9384

Fax

(206) 364-0076

NPI assigned

Oct 18, 2006

Last updated

Sep 11, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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

• Counseling Centers of North Puget Sound

  • Professional Counselor
  • Snohomish, WA
  • NPI 1376673566
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1710068598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 292",
            "address_2": "1306 LAKEVIEW DRIVE",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982910292",
            "telephone_number": "360-568-8737",
            "fax_number": "360-568-1654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17440 BROOKSIDE BLVD NE",
            "city": "LAKE FOREST PARK",
            "state": "WA",
            "postal_code": "98155",
            "telephone_number": "206-366-9384",
            "fax_number": "206-364-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAQUES",
        "first_name": "SHARI",
        "middle_name": "SYRDAL",
        "name_prefix": "Mrs.",
        "credential": "ARNP MN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30004096",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00044602",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachelle M Friskey, LMHCA
• Kristina Sylla Fury
• Clarissa Garza, LMHC-A
• Robert Allison Gotshall, MD
• Infinitasks LLC
• Anthony Reed Johnson, LMP
• Mark Daniel Johnson, L.AC.
• Susan Lee Jones-Kubeska, DO
• Rachael Johannah Katz, PCD, CLE
• Kelley Cares LLC

• Nurse Practitioner in Lake Forest Park, WA
• Providers in Lake Forest Park, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.