Individual provider Active NPI

Brendan Haughie Jackson-Fowl, DO

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1477297109
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP61295493 Issued in WA
Practice address
1401 Madison St Ste 100
Seattle, WA 98104-1316
Phone
(206) 386-6111
Fax
(206) 386-6113
NPI assigned
Apr 27, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP61295493 WA Primary

Addresses

Primary practice location

1401 Madison St Ste 100
Seattle, WA 98104-1316

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 386-6111

Other practice location 1

1801 NW Market St Ste 403
Seattle, WA 98107-3901
Phone (206) 297-5100

Other identifiers 1

IdentifierTypeStateIssuer
2208498MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250714003392 WA Practitioner - Family Practice 4385023837 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Touro Un Col of Osteopathic Medicine, New York, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians
Valley Medical Group-RentonGroup PAC ID 4183753965, 419 clinicians

Practice addresses (Care Compare)

1401 Madison St
Suite 100
Seattle, WA 98104-1316
Phone (206) 386-6111

3915 Talbot Rd S
Suite 401
Renton, WA 98055-5738
Phone (425) 656-4224

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Group-Renton Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Swedish Health Services CurrentSince Jul 7, 2025 Accepting new patients
Swedish Health Services Past Accepting new patients

Locations

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800

3915 Talbot Rd S
Ste 401
Renton, WA 98055
Phone (425) 656-4224

1801 Lind Ave SW
Renton, WA 98057

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

1401 Madison St
Ste 100
Seattle, WA 98104
Phone (206) 386-6111

1401 Madison St
#100
Seattle, WA 98104
Phone (206) 386-6054

1801 NW Market St
Ste 403
Seattle, WA 98107
Phone (206) 297-5100

Interoperability endpoints

  • Direct secure messaging: bjacksonfowl814594@direct.ochin.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1651017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1477297109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-386-6111",
            "fax_number": "206-386-6113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MADISON ST STE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041316",
            "telephone_number": "206-386-6111",
            "fax_number": "206-386-6113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 NW Market St Ste 403",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981073901",
            "country_code": "US",
            "telephone_number": "206-297-5100",
            "fax_number": "206-297-5151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON-FOWL",
        "first_name": "BRENDAN",
        "middle_name": "HAUGHIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-27",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61295493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2208498",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.