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CARPENTER HEALTH PLLC

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Company Details

Legal Name: CARPENTER HEALTH PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: July 25th 2022
Expiration date: 31 Jul 2026
UBI Number: 604 943 280
ZIP code: 99403
City: Clarkston
County: ASOTIN
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 1372 BRIDGE ST, CLARKSTON, WA, 99403-2332, UNITED STATES

Contact Details

E-Mail: T.CARPENTERHEALTH@GMAIL.COM
Phone Number: +1 509-758-9524

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
TODD CARPENTER Registered Agent 356 WITTERS CT, CLARKSTON, WA, 99403-8702, UNITED STATES

Key Officers & Management

Name Role Address
TODD CARPENTER Executor 1268 BRIDGE ST, CLARKSTON, WA, 99403-2219, UNITED STATES
TODD CARPENTER Governing Person 1268 BRIDGE ST, CLARKSTON, WA, 99403-2219, UNITED STATES

National Provider Identifier

NPI Number:
1427776319
Certification Date:
2023-07-18

Authorized Person:

Name:
TODD CARPENTER
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
363LP2300X - Primary Care Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
Yes

Contacts:

Fax:
5097588258
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