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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 2 years ago

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.

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Identifiers

StateTypeNumberIssuer
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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