Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Adam John Fishback

Individual provider Registered Nurse · NPI 1083295166

Adam John Fishback is a Certified Registered Nurse Anesthetist (CRNA) in Clackamas, Oregon. Qualified in 2021, 5 years ago. Practices with Kaiser Foundation Health Plan of the Northwest, a 1,811-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
5
Licensed in
OR
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone: (503) 813-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 202111766CRNA-PP (OR)
Registered Nurse Taxonomy 163W00000X · Licence 201390444RN (OR)

Record details

NPI number1083295166
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 20, 2021
Last updated in NPPESAugust 13, 2025
Certification dateAugust 13, 2025
Mailing address500 Ne Multnomah St Fl 11, Portland, OR 97232-2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Kaiser Foundation Health Plan Of The Northwest — 1811 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Clackamas