BENJAMIN HSU, M.D., P.S.

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Company Details

Legal Name:	BENJAMIN HSU, M.D., P.S.
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL SERVICE CORPORATION
Category:	DOMESTIC ENTITY
Status:	Active
Formation/ Registration Date:	February 16th 1999
Expiration date:	28 Feb 2026
UBI Number:	601 932 900
ZIP code:	99218
City:	Spokane
County:	SPOKANE
Home State:	WASHINGTON
Principal Office Street Address:	757 E HOLLAND AVE, SPOKANE, WA, 99218-1257, UNITED STATES
Supporting healthcare providers fighting with COVID-19:	$92,110

Contact Details

E-Mail:	TOLIVERSON@NORTHWESTDERM.COM
Phone Number:	+1 509-444-6367

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name	Role	Address
BENJAMIN HSU	Registered Agent	757 E HOLLAND AVE, SPOKANE, WA, 99218-1257, UNITED STATES

Key Officers & Management

Name	Role
BENJAMIN HSU	Governing Person

National Provider Identifier

NPI Number:

1750496642

Link:

View on NPI website

Authorized Person:

Name:

BENJAMIN HSU

Role:

OWNER/PHYSICIAN

Phone:

5094446367

Taxonomy:

Selected Taxonomy:

207N00000X - Dermatology Physician

Is Primary:

Yes

Contacts:

Phone:

+1 509-444-6367

Fax:

5094446371

Form 5500 Series

Employer Identification Number (EIN):

911945683

Plan Year:

2024

Number Of Participants:

27

Plan Name:

401(K)

Sponsor's telephone number:

5094446367

File:

Plan Administrator / Signatory:

TAMARA OLIVERSON(Plan administrator)

Plan Year:

2023

Number Of Participants:

24

Plan Name:

401(K)

Sponsor's telephone number:

5094446367

File:

Plan Administrator / Signatory:

TAMARA OLIVERSON(Plan administrator)

Plan Year:

2022

Number Of Participants:

23

Plan Name:

401(K)

Sponsor's telephone number:

5094446367

File:

Plan Administrator / Signatory:

TAMARA OLIVERSON(Plan administrator)

Plan Year:

2021

Number Of Participants:

25

Plan Name:

401(K)

Sponsor's telephone number:

5094446367

File:

Plan Administrator / Signatory:

TAMARA OLIVERSON(Plan administrator)

Plan Year:

2020

Number Of Participants:

23

Plan Name:

401(K)

Sponsor's telephone number:

5094446367

File:

Plan Administrator / Signatory:

TAMARA OLIVERSON(Plan administrator)

Paycheck Protection Program

Jobs Reported:

25

Initial Approval Amount:

$252,800

Date Approved:

2020-04-04

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$252,800

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$254,254.47

Servicing Lender:

State Bank Northwest

Use of Proceeds:

Payroll: $202,300
Utilities: $3,200
Rent: $22,300
Healthcare: $25000

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