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DR. JACK MARK FISHAUT MD
NPI 1891779195
Pediatrics in Friday Harbor, WA

Active since December 01, 2005
235 BLAIR AVE, FRIDAY HARBOR, WA 98250(360) 370-5971(360) 370-5980 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Mar 7, 2023, Feb 22, 2022, Feb 11, 2022 (3 updates tracked since 2022).

About Dr. Jack Mark Fishaut Md NPPES

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

DR. JACK MARK FISHAUT MD (NPI 1891779195) is an individual pediatrics provider in Friday Harbor, Washington, licensed in Washington (MD00040965) and active in the NPI registry since December 2005.

NPPES Registry Identity

NPI1891779195
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDR. JACK MARK FISHAUTCredential: MD
Location Address235 BLAIR AVEFriday Harbor, WA 98250-0796
Mailing AddressPo Box 796Friday Harbor, WA 98250-0796 · (360) 370-5971 · Fax (360) 370-5980
Phone(360) 370-5971
Fax(360) 370-5980
Sole ProprietorNo
Enumeration DateDecember 1, 2005
Last NPPES UpdateMarch 7, 20233 updates tracked since enumeration
NPPES CertifiedFebruary 11, 2022
✔ NPI 1891779195 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in WA · MD00040965
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
235 BLAIR AVE, Friday Harbor, WA 98250
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Other Identifiers 10

Other361929500Park Natl L & L
Other532300004Group Health
Other4952FIRegence Blue Shield
Other912109329Uniform
Other912109329Chpw
Other912109329Premera Blue Cross
OtherLABOR AND INDUSTRIES0182789
Other8387367Dshs Medicaid
Other912109329First Choice
Other8930937Crime Victims

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

Other Providers at the Same Location NPPES

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

FRIDAY HARBOR FAMILY CLINIC PLLC
Clinic/Center
235 BLAIR AVE
FRIDAY HARBOR, WA 98250
San Juan County (360) 370-5971

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 Fishaut's NPI number?

The NPI number for Jack Fishaut is 1891779195. It was assigned to this individual provider in the NPPES registry on December 1, 2005.

Where is Jack Fishaut located?

Jack Fishaut practices at 235 Blair Ave, Friday Harbor, WA 98250. The listed phone number is (360) 370-5971.

What is Jack Fishaut's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

What insurance does Jack Fishaut accept?

Health plans from PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Jack Fishaut 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 Fishaut was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.