Fishaut, Jack Mark
Fishaut, Jack Mark is an individual health care provider with primary practice located at 235 Blair Ave , Friday Harbor WA 98250-0796. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Fishaut, Jack Mark can be contacted via phone (360) 370-5971.Contact Information
Primary practice address
235 Blair Ave
Friday Harbor WA 98250-0796
Phone: (360) 370-5971
Fax: (360) 370-5980
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD00040965 | Washington |
Profile Details
NPI number | 1891779195 |
---|---|
LBN Legal business name | Fishaut, Jack Mark |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Dec 1st, 2005 |
Last updated | Mar 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1891779195 | NPPES |
Other | 361929500 | PARK NATL L & L | |
Other | 532300004 | PARK NATL L & L | |
Other | 4952FI | PARK NATL L & L | |
Other | 912109329 | PARK NATL L & L | |
Other | 912109329 | PARK NATL L & L | |
Other | 912109329 | PARK NATL L & L | |
Other | LABOR AND INDUSTRIES | PARK NATL L & L | |
Other | 8387367 | PARK NATL L & L | |
Other | 912109329 | PARK NATL L & L | |
Other | 8930937 | PARK NATL L & L |
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