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BEHAVIORAL HEALTH COLLABORATIVE, PLLC

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Company Details

Legal Name: BEHAVIORAL HEALTH COLLABORATIVE, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Voluntarily Dissolved
Formation/ Registration Date: November 22nd 2017
Date of Dissolution: December 20th 2022
Expiration date: 30 Nov 2022
UBI Number: 604 194 259
ZIP code: 98133
City: Seattle
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 10740 MERIDIAN AVE N STE 107, SEATTLE, WA, 98133-9010, UNITED STATES

Contact Details

E-Mail: JAMESELOLLEY@GMAIL.COM
Phone Number: +1 206-420-3506

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
JAMES LOLLEY Registered Agent 10740 MERIDIAN AVE N STE 107, SEATTLE, WA, 98133-9010, UNITED STATES

Key Officers & Management

Name Role Address
JAMES LOLLEY Governing Person 2800 E MADISON ST STE 304, SEATTLE, WA, 98112-4865, UNITED STATES
DEREK W WOOLSTON EXECUTOR 1601 5TH AVE STE 2040, SEATTLE, WA, 98101-1627, UNITED STATES

National Provider Identifier

NPI Number:
1639685241

Authorized Person:

Name:
DR. JAMES EDWARD LOLLEY
Role:
CO-OWNER
Phone:

Taxonomy:

Selected Taxonomy:
103TC0700X - Clinical Psychologist
Is Primary:
No
Selected Taxonomy:
2084P0800X - Psychiatry Physician
Is Primary:
Yes

Contacts:

Fax:
2064329437
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