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BLOSSOM MENTAL HEALTH SERVICES PLLC

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Company Details

Legal Name: BLOSSOM MENTAL HEALTH SERVICES PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: April 29th 2023
Expiration date: 30 Apr 2026
UBI Number: 605 234 012
ZIP code: 98201
City: Everett
County: SNOHOMISH
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 2722 COLBY AVE STE 328, EVERETT, WA, 98201-3531, UNITED STATES

Contact Details

E-Mail: SANDY.SIHOTA83@GMAIL.COM
Phone Number: +1 425-939-7411

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
SANDEEP GREWAL Registered Agent 19930 13TH DR SE, BOTHELL, WA, 98012-7103, UNITED STATES

Key Officers & Management

Name Role Address
SANDEEP GREWAL Executor 18501 28TH AVE SE, BOTHELL, WA, 98012-8817, UNITED STATES
SANDEEP GREWAL Governing Person -

National Provider Identifier

NPI Number:
1003596412
Certification Date:
2023-07-20

Authorized Person:

Name:
SANDEEP GREWAL
Role:
MANAGER/OWNER
Phone:

Taxonomy:

Selected Taxonomy:
363LP0808X - Psychiatric/Mental Health Nurse Practitioner
Is Primary:
Yes

Contacts:

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