Individual provider Active NPI

Jacob Benjamin Brent, M.D.

  • Psychiatry Physician
  • Everett, WA
National Provider Identifier
1508354887
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD61518406 Issued in WA
Practice address
1321 Colby Ave
Everett, WA 98201-1665
Phone
(425) 258-7390
NPI assigned
Apr 23, 2018
Last updated
Sep 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X MD61518406 WA
Psychiatry Physician 2084P0800X MD61518406 WA Primary

Addresses

Primary practice location

1321 Colby Ave
Everett, WA 98201-1665

Mailing address

PO Box 3360
Portland, OR 97208-3360
Phone (866) 747-2455

Other practice location 1

3800 Ohara Street
E502; attn Kim Kirchner
Pittsburgh, PA 15213
Phone (412) 246-5320

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
I20240930002979 WA Practitioner - Psychiatry 1759637689 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services-Wa CurrentSince Oct 7, 2024 Accepting new patients
Providence Health & Services- Washington CurrentSince Oct 7, 2024 Accepting new patients
Providence Health & Services - Washington CurrentSince Oct 7, 2024 Accepting new patients
Providence Health & Services-Wa Current Accepting new patients
Providence Health & Services-Washington CurrentSince Oct 7, 2024 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
Western Psychological and Counseling Services LLC CurrentSince Jan 11, 2026 Accepting new patients
Western Psychological and Counseling Services LLC Psychiatry PastSince Jan 11, 2026 Accepting new patients

Locations

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

900 Pacific Ave
Fl 5
Everett, WA 98201
Phone (425) 258-7311

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

1448 NW Market St
Ste 210
Seattle, WA 98107
Phone (206) 910-9476

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.jacobbrent@147765.advancedmd-direct.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1508354887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 COLBY AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011665",
            "telephone_number": "425-258-7390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 Ohara Street",
            "address_2": "E502; attn Kim Kirchner",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "15213",
            "country_code": "US",
            "telephone_number": "412-246-5320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRENT",
        "first_name": "JACOB",
        "middle_name": "BENJAMIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-23",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "MD61518406",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD61518406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.