Provider Demographics
NPI:1043731227
Name:KEENER, JENNIFER JOY (MSSW, MHP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JOY
Last Name:KEENER
Suffix:
Gender:F
Credentials:MSSW, MHP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:JOY
Other - Last Name:POTTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1501 N 200TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-3301
Mailing Address - Country:US
Mailing Address - Phone:206-459-6298
Mailing Address - Fax:
Practice Address - Street 1:1501 N 200TH ST STE 103
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-3301
Practice Address - Country:US
Practice Address - Phone:206-459-6298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical