Provider Demographics
NPI:1992387013
Name:DELANEY, JENAFER K (LSWAIC)
Entity Type:Individual
Prefix:
First Name:JENAFER
Middle Name:K
Last Name:DELANEY
Suffix:
Gender:F
Credentials:LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LAKE BELLEVUE DR STE 214
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2454
Mailing Address - Country:US
Mailing Address - Phone:206-853-7364
Mailing Address - Fax:
Practice Address - Street 1:11416 SLATER AVE NE STE 100
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-4600
Practice Address - Country:US
Practice Address - Phone:206-741-0742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA611578061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty