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AMANECER MIND MEDICINE PLLC

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Company Details

Legal Name: AMANECER MIND MEDICINE PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Voluntarily Dissolved
Formation/ Registration Date: July 14th 2022
Date of Dissolution: December 26th 2024
Expiration date: 31 Jul 2025
UBI Number: 604 941 976
ZIP code: 99163
City: Pullman
County: WHITMAN
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 167 NE KAMIAKEN ST, PULLMAN, WA, 99163-2611, UNITED STATES

Contact Details

E-Mail: ERIK.BAYONA@GMAIL.COM

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
NORTHWEST REGISTERED AGENT, LLC Registered Agent 522 W RIVERSIDE AVE STE N, SPOKANE, WA, 99201-0581, UNITED STATES

Key Officers & Management

Name Role Address
ERIK BAYONA Executor 300 SW SHIRLEY ST, PULLMAN, WA, 99163-2730, UNITED STATES
ERIK BAYONA Governing Person -

National Provider Identifier

NPI Number:
1962112508
Certification Date:
2023-01-09

Authorized Person:

Name:
ERIK BAYONA
Role:
PSYCHIATRIST/OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
Is Primary:
Yes

Contacts:

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