104TH AVENUE MEDICAL CLINIC, INCORPORATED

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Company Details

Legal Name:	104TH AVENUE MEDICAL CLINIC, INCORPORATED
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFIT CORPORATION
Category:	DOMESTIC ENTITY
Status:	Active
Formation/ Registration Date:	June 29th 2000
Expiration date:	30 Jun 2026
UBI Number:	602 049 746
ZIP code:	98030
City:	Kent
County:	KING
Home State:	WASHINGTON
Principal Office Street Address:	24604 104TH AVE SE STE 202, KENT, WA, 98030-5385, UNITED STATES
Principal Office Mailing Address:	12505 NE BEL RED RD, BELLEVUE, WA, 98005, UNITED STATES
Supporting healthcare providers fighting with COVID-19:	$14,193

Contact Details

E-Mail:	MIKE@TAXPROFESSIONALSNW.COM
Phone Number:	+1 253-653-4227

Nature of Business

Professional, Scientific & Technical Services, Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name	Role	Address
MANOJ K DIPANKAR	Registered Agent	24604 104TH AVE SE STE 202, KENT, WA, 98030-5385, UNITED STATES

Key Officers & Management

Name	Role	Address
MANOJ DIPANKAR	Governing Person	5670 152ND AVENUE SE, BELLEVUE, WA, 98006, UNITED STATES
RANU CHOUDHARY	Governing Person	5670 152ND AVENUE SE, BELLEVUE, WA, 98006, UNITED STATES

National Provider Identifier

NPI Number:

1396921326

Link:

View on NPI website

Authorized Person:

Name:

RANU CHOUDHARY

Role:

VICE-PRESIDENT

Phone:

2538598371

Taxonomy:

Selected Taxonomy:

261Q00000X - Clinic/Center

Is Primary:

Yes

Contacts:

Phone:

+1 253-859-8371

Fax:

2538599593

Paycheck Protection Program

Jobs Reported:

Initial Approval Amount:

$31,700

Date Approved:

2020-04-14

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$31,700

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$32,071.72

Servicing Lender:

Customers Bank

Use of Proceeds:

Payroll: $31,700

Jobs Reported:

Initial Approval Amount:

$29,880

Date Approved:

2021-01-30

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$29,880

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$30,171.33

Servicing Lender:

Itria Ventures LLC

Use of Proceeds:

Payroll: $29,874
Utilities: $1

Labor Condition Applications

Case Number:

I-200-10162-664810

Job Title:

BUSINESS SYSTEMS ANALYST

SOC (ONET/OES) code:

15-1051.00

SOC (ONET/OES) occupation title:

Computer Systems Analysts

Begin Date:

2010-10-15

End Date:

2013-10-14

Employment and Wage Information

Address:

KENT, WA

Wage Rate Paid to Nonimmigrant Workers:

$28.3

Prevailing Wage Rate:

$28.3

Case Number:

I-08086-4133067

Program:

H-1B

Job Title:

MANAGEMENT ANALYST

SOC (ONET/OES) occupation title:

OCCUPATIONS IN SYSTEMS ANALYSIS AND PROGRAMMING

Begin Date:

2008-09-26

End Date:

2011-09-26

Employment and Wage Information

Address:

Kent, WA

Wage Rate Paid to Nonimmigrant Workers:

$55,000

Per:

Prevailing Wage Rate:

$54,558

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104TH AVENUE MEDICAL CLINIC, INCORPORATED

Is this your business?

Company Details

Contact Details

Nature of Business

Reviews Leave a review

Registered Agent Information

Key Officers & Management

National Provider Identifier

Authorized Person:

Taxonomy:

Contacts:

Paycheck Protection Program

Labor Condition Applications

Employment and Wage Information

Employment and Wage Information

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