ADVANCED DIABETES AND ENDOCRINE CARE PLLC

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Company Details

Legal Name:	ADVANCED DIABETES AND ENDOCRINE CARE PLLC
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Merged
Formation/ Registration Date:	July 21st 2014
Date of Dissolution:	September 9th 2024
Expiration date:	31 Jul 2025
UBI Number:	603 421 508
ZIP code:	98003
City:	Federal Way
County:	KING
Home State:	WASHINGTON
Principal Office Street Address:	700 S 320TH ST STE D, FEDERAL WAY, WA, 98003-4691, UNITED STATES
Principal Office Mailing Address:	700 S 320TH ST, FEDERAL WAY, FEDERAL WAY, WA, 98003-4691, UNITED STATES
Supporting healthcare providers fighting with COVID-19:	$2,656

Contact Details

E-Mail:	QUDDUSI@ADECARE.ORG
Phone Number:	+1 253-204-3648

Nature of Business

Health Care, Social Assistance & Service Organization, HEALTH CARE, MEDICAL CLINIC

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Registered Agent Information

Name	Role	Address
SHAISTA QUDDUSI-ANSARI	Registered Agent	700 S 320TH ST STE D, FEDERAL WAY, WA, 98003-4691, UNITED STATES

Key Officers & Management

Name	Role	Address
SHAISTA QUDDUSI, MD	Governing Person	700 S 320TH ST STE D, FEDERAL WAY, WA, 98003, UNITED STATES

National Provider Identifier

NPI Number:

1518375880

Link:

View on NPI website

Authorized Person:

Name:

DR. SHAISTA A QUDDUSI

Role:

PRESIDENT

Phone:

2538801029

Taxonomy:

Selected Taxonomy:

207RE0101X - Endocrinology, Diabetes & Metabolism Physician

Is Primary:

Yes

Contacts:

Phone:

+1 253-880-1029

Fax:

2533226203

Form 5500 Series

Employer Identification Number (EIN):

471268477

Plan Year:

2022

Number Of Participants:

3

Plan Name:

401(K)

Sponsor's telephone number:

2538801029

File:

Plan Administrator / Signatory:

SHAISTA QUDDUSI-ANSARI(Plan administrator) SHAISTA QUDDUSI-ANSARI(Employer/plan sponsor)

Plan Year:

2021

Number Of Participants:

3

Plan Name:

401(K)

Sponsor's telephone number:

2538801029

File:

Plan Administrator / Signatory:

SHAISTA ANSARI(Plan administrator) SHAISTA ANSARI(Employer/plan sponsor)

Plan Year:

2020

Number Of Participants:

3

Plan Name:

401(K)

Sponsor's telephone number:

2538801029

File:

Plan Administrator / Signatory:

SHAISTA QUDDUSI-ANSARI(Plan administrator) SHAISTA QUDDUSI-ANSARI(Employer/plan sponsor)

Plan Year:

2019

Number Of Participants:

3

Plan Name:

401(K)

Sponsor's telephone number:

2538801029

File:

Plan Administrator / Signatory:

SHAISTA QUDDUSI-ANSARI(Plan administrator) SHAISTA QUDDUSI-ANSARI(Employer/plan sponsor)

Plan Year:

2018

Number Of Participants:

3

Plan Name:

401(K)

Sponsor's telephone number:

2538801029

File:

Plan Administrator / Signatory:

SHAISTA QUDDUSI-ANSARI(Plan administrator) SHAISTA QUDDUSI-ANSARI(Employer/plan sponsor)

Paycheck Protection Program

Jobs Reported:

3

Initial Approval Amount:

$37,800

Date Approved:

2020-06-24

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$37,800

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$37,931.52

Servicing Lender:

Coastal Community Bank

Use of Proceeds:

Payroll: $37,800

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