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BALLARD PEDIATRIC CLINIC, INC., P.S.

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Company Details

Legal Name: BALLARD PEDIATRIC CLINIC, INC., P.S.
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL SERVICE CORPORATION
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: January 2nd 1990
Expiration date: 31 Jan 2026
UBI Number: 601 212 797
ZIP code: 98117
City: Seattle
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 7554 15TH AVE NW, SEATTLE, WA, 98117-5409, UNITED STATES

Contact Details

E-Mail: RA@LASHER.COM

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
EUGENE W WONG Registered Agent 601 UNION ST STE 2600, SEATTLE, WA, 98101-4000, UNITED STATES

Key Officers & Management

Name Role Address
CHRISTIANNE ELDRED MD Governing Person 7554 15TH AVENUE N W, SEATTLE, WA, 98117, UNITED STATES
KATHRYN H DEL BECCARO MD Governing Person 7554 15TH AVENUE N W, SEATTLE, WA, 98117, UNITED STATES
MATTHEW H ALLEN MD Governing Person 7554 15TH AVENUE N W, SEATTLE, WA, 98117, UNITED STATES
TIMOTHY R HALL PHD MD Governing Person 7554 15TH AVE NW, SEATTLE, WA, 98117, UNITED STATES
DANAE NAKONECZNY MD Governing Person -
DAVID BOWE MD Governing Person -
MARIA RECORDS, MD Governing Person -
ANNE PERCIVAL MD Governing Person -

National Provider Identifier

NPI Number:
1487876918
Link:
View on NPI website

Authorized Person:

Name:
ROBERT W TELZROW
Role:
CEO
Phone:
2067839300

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Phone:
+1 206-783-9300
Fax:
2067898404

Form 5500 Series

Employer Identification Number (EIN):
911463239
Plan Year:
2015
Number Of Participants:
29
Plan Name:
401(K)
Sponsor's telephone number:
2067833524
File:
View File
Plan Administrator / Signatory:
JANINE PETERSON(Plan administrator) JANINE PETERSON(Employer/plan sponsor)
Plan Year:
2014
Number Of Participants:
25
Plan Name:
401(K)
Sponsor's telephone number:
2067833524
File:
View File
Plan Administrator / Signatory:
TIMOTHY HALL(Plan administrator) TIMOTHY HALL(Employer/plan sponsor)
Plan Year:
2013
Number Of Participants:
24
Plan Name:
401(K)
Sponsor's telephone number:
2067833524
File:
View File
Plan Administrator / Signatory:
TIMOTHY HALL(Plan administrator) TIMOTHY HALL(Employer/plan sponsor)
Plan Year:
2012
Number Of Participants:
25
Plan Name:
401(K)
Sponsor's telephone number:
2067833524
File:
View File
Plan Administrator / Signatory:
TIMOTHY HALL(Plan administrator) TIMOTHY HALL(Employer/plan sponsor)
Plan Year:
2011
Number Of Participants:
23
Plan Name:
401(K)
Sponsor's telephone number:
2067833524
File:
View File
Plan Administrator / Signatory:
JANINE PETERSON(Plan administrator) JANINE PETERSON(Employer/plan sponsor)

Paycheck Protection Program

Jobs Reported:
31
Initial Approval Amount:
$628,180
Date Approved:
2021-01-20
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$628,180
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$636,241.64
Servicing Lender:
Peoples Bank
Use of Proceeds:
Payroll: $628,178
Utilities: $1
Jobs Reported:
31
Initial Approval Amount:
$628,100
Date Approved:
2020-04-15
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$628,100
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$633,648.22
Servicing Lender:
Peoples Bank
Use of Proceeds:
Payroll: $628,100

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