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JACK EISAMAN PA-C
NPI 1356794432
Physician Assistant - Medical in Stanwood, WA

Active since July 13, 2016PECOS Enrolled
9631 269TH ST NW, STANWOOD, WA 98292(360) 629-1600(360) 629-1644 Get Directions Write a Review

NPPES record last updated: March 30, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 30, 2021, Nov 3, 2016, Jul 13, 2016 (3 updates tracked since 2016).

About Jack Eisaman Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK EISAMAN PA-C (NPI 1356794432) is an individual medical provider in Stanwood, Washington, licensed in Washington (PA60686334) and active in the NPI registry since July 2016. He is enrolled in Medicare PECOS and maintains a secondary practice location in Everett.

NPPES Registry Identity

NPI1356794432
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameJACK EISAMANCredential: PA-C
Location Address9631 269TH ST NWStanwood, WA 98292-8071
Mailing Address1400 E Kincaid St, Attn: CredentialingMount Vernon, WA 98274-4127 · (360) 428-2500 · Fax (360) 428-6485
Phone(360) 629-1600
Fax(360) 629-1644
Sole ProprietorNo
Enumeration DateJuly 13, 2016
Last NPPES UpdateMarch 30, 20213 updates tracked since enumeration
NPPES CertifiedMarch 30, 2021
✔ NPI 1356794432 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in WA · PA60686334
Also ListedPhysician AssistantTaxonomy 363A00000X · License PA60686334 (WA)
9631 269TH ST NW, Stanwood, WA 98292
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Other Names 1

Other Name (5)Jackson Eisaman

Secondary Practice Location 1

Location 12930 Maple StEverett, WA 98201-3832 · Phone (425) 261-1500

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack Eisaman Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PATRICK A CLARK MD
Family Medicine
9631 269TH ST NW
STANWOOD, WA 98292
Snohomish County (360) 629-1600
CAROL L HOEKSEMA MD
Family Medicine
9631 269TH ST NW
STANWOOD, WA 98292
Snohomish County (360) 629-1600
SAFE HARBOR FREE CLINIC
Voluntary or Charitable
9631 269TH ST NW
STANWOOD, WA 98292
Snohomish County (425) 870-7384
SAFE HARBOR FREE CLINIC
Clinic/Center (Community Health)
9631 269TH ST NW
STANWOOD, WA 98292
Snohomish County (425) 870-7384
DR. ARNOLD ANDRE RONNING M.D.
Pediatrics
9631 269TH ST NW
STANWOOD, WA 98292
Snohomish County (425) 870-7384
OKSANA S MILLER DO
Family Medicine
9631 269TH ST NW
STANWOOD, WA 98292
Snohomish County (360) 629-1600
SKAGIT VALLEY MEDICAL CENTER
General Practice
9631 269TH ST NW
STANWOOD, WA 98292
Snohomish County (360) 629-1600
SKAGIT VALLEY MEDICAL CENTER, INC PS
General Practice
9631 269TH ST NW
STANWOOD, WA 98292
Snohomish County (360) 629-1600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Eisaman's NPI number?

The NPI number for Jack Eisaman is 1356794432. It was assigned to this individual provider in the NPPES registry on July 13, 2016. The provider is also known as Jackson Eisaman.

Where is Jack Eisaman located?

Jack Eisaman practices at 9631 269th St NW, Stanwood, WA 98292. The listed phone number is (360) 629-1600.

What is Jack Eisaman's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Jack Eisaman enrolled in Medicare?

Yes. Jack Eisaman is registered in the Medicare PECOS enrollment system.

What insurance does Jack Eisaman accept?

Health plans from PacificSource Health Plans list Jack Eisaman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jack Eisaman was last updated on March 30, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.