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BELLINGHAM UROLOGY SPECIALISTS, PLLC

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Company Details

Legal Name: BELLINGHAM UROLOGY SPECIALISTS, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: November 17th 2005
Date of Dissolution: April 30th 2015
Expiration date: 30 Nov 2015
UBI Number: 602 558 844
ZIP code: 98225
City: Bellingham
County: WHATCOM
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 340 BIRCHWOOD AVE, BELLINGHAM, WA, 98225, UNITED STATES

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Key Officers & Management

Name Role Address
LONNI DODD Governing Person 340 BIRCHWOOD, BELLINGHAM, WA, 98225, UNITED STATES
JOHN PETTIT Governing Person 340 BIRCHWOOD AVE, BELLINGHAM, WA, 98225, UNITED STATES
SOREN CARLSEN Governing Person 340 BIRCHWOOD AVE, BELLINGHAM, WA, 98225, UNITED STATES
S O'KEEFE Governing Person 340 BIRCHWOOD AVE, BELLINGHAM, WA, 98225, UNITED STATES

National Provider Identifier

NPI Number:
1467537951

Authorized Person:

Name:
DR. JOHN MARK PETTIT
Role:
OWNER DOCTOR
Phone:

Taxonomy:

Selected Taxonomy:
261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
3606767730

Form 5500 Series

Employer Identification Number (EIN):
203852254
Plan Year:
2013
Number Of Participants:
23
Plan Name:
RETIREMENT PLAN
Sponsor's telephone number:
Plan Administrator / Signatory:
JOHN PETTIT, MD(Plan administrator)
Plan Year:
2012
Number Of Participants:
18
Plan Name:
RETIREMENT PLAN
Sponsor's telephone number:
Plan Administrator / Signatory:
JOHN PETTIT(Plan administrator)
Plan Year:
2011
Number Of Participants:
14
Plan Name:
RETIREMENT PLAN
Sponsor's telephone number:
Plan Administrator / Signatory:
JOHN M. PETTIT(Plan administrator)
Plan Year:
2010
Number Of Participants:
0
Plan Name:
RETIREMENT PLAN
Sponsor's telephone number:
Plan Administrator / Signatory:
JOHN M. PETTIT(Plan administrator)
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