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CASCADE NEUROLOGIC CLINIC, INC. P.S.

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Company Details

Legal Name: CASCADE NEUROLOGIC CLINIC, INC. P.S.
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL SERVICE CORPORATION
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: December 1st 1975
Date of Dissolution: May 3rd 2019
Expiration date: 31 Dec 2018
UBI Number: 600 182 628
ZIP code: 98274
City: Mount Vernon
County: SKAGIT
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 1315 E DIVISION ST, MOUNT VERNON, WA, 98274-4134, UNITED STATES
Principal Office Mailing Address: Google Maps Logo PO BOX 2917, MOUNT VERNON, WA, 98273-7917, UNITED STATES

Contact Details

E-Mail: HGOLDSTON@GMAIL.COM

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Registered Agent Information

Name Role Address
HERBERT J GOLDSTON JR MD Registered Agent 1315 E DIVISION, MOUNT VERNON, WA, 98274-0000, UNITED STATES

Key Officers & Management

Name Role Address
SHARON ELLIOTT Governing Person 1315 EAST DIVISION STREET, MOUNT VERNON, WA, 98274, UNITED STATES
HERBERT GOLDSTON Governing Person 1315 EAST DIVISION STREET, MOUNT VERNON, WA, 98274, UNITED STATES
DAVID MORRIS Governing Person 1315 EAST DIVISION STREET, MOUNT VERNON, WA, 98274, UNITED STATES

National Provider Identifier

NPI Number:
1194937037

Authorized Person:

Name:
SHARON S. ELLIOTT
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
261QM2500X - Medical Specialty Clinic/Center
Is Primary:
No
Selected Taxonomy:
174400000X - Specialist
Is Primary:
Yes

Contacts:

Fax:
3604248953

Form 5500 Series

Employer Identification Number (EIN):
910951358
Plan Year:
2019
Number Of Participants:
1
Plan Name:
401(K)
Sponsor's telephone number:
Plan Administrator / Signatory:
HERBERT GOLDSTON(Plan administrator) HERBERT GOLDSTON(Employer/plan sponsor)
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