Individual
DR. JACQUELINE SIY TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2005 W MAIN ST STE 110, BATTLE GROUND, WA 98604
(360) 882-2778
(360) 604-1762
Mailing address
700 NE 87TH AVE, VANCOUVER, WA 98664-4896
(360) 882-2778
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
51642
MN
207Q00000X
Family Medicine Physician
Primary
MD60819201
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2107101
—
WA
Enumeration date
01/15/2008
Last updated
10/08/2018
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