Individual
DR. JACK MARK FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3417 ENSIGN RD NE, OLYMPIA, WA 98506-5075
(360) 493-4600
(360) 493-4603
Mailing address
19020 33RD AVE W STE 210, LYNNWOOD, WA 98036-4748
(425) 563-1500
(425) 563-1374
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD00045508
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0207711
LNI-SOUTH SOUND RADIOLOGY
WA
01
—
0384204
LNI-RADIA
WA
05
—
1043717
—
WA
05
—
8450157
—
WA
Enumeration date
03/08/2006
Last updated
12/30/2025
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