Provider Demographics
NPI:1588186274
Name:SILOAM PARTNERS INC
Entity Type:Organization
Organization Name:SILOAM PARTNERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:360-624-0152
Mailing Address - Street 1:16821 SE MCGILLIVRAY BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-0402
Mailing Address - Country:US
Mailing Address - Phone:360-433-9580
Mailing Address - Fax:866-824-5107
Practice Address - Street 1:16821 SE MCGILLIVRAY BLVD STE 204
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-0402
Practice Address - Country:US
Practice Address - Phone:360-433-9580
Practice Address - Fax:866-824-5107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty