IndividualActive
Jack Eisaman, PA-C
NPI 1356794432 · Medical Physician Assistant · Stanwood, WA
Provider details
- NPI number
- 1356794432
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- PA60686334 (WA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
9631 269th St Nw
Stanwood, WA 98292-8071
Phone: (360) 629-1600
Fax: (360) 629-1644
Street-level locationGet directions
Mailing address
1400 E Kincaid St
Mount Vernon, WA 98274-4127
Additional practice locations (1)
- 2930 Maple StEverett, WA 98201-3832Phone: (425) 261-1500
Registry dates
- Enumerated
- 2016-07-13
- Last updated
- 2021-03-30
- Certified
- 2021-03-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.