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CEDAR CREST WHOLE HEALTH MEDICAL CENTER P.L.L.C.

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Company Details

Legal Name: CEDAR CREST WHOLE HEALTH MEDICAL CENTER P.L.L.C.
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: December 30th 1999
Date of Dissolution: May 3rd 2023
Expiration date: 31 Dec 2022
UBI Number: 602 002 062
ZIP code: 98532
City: Chehalis
County: LEWIS
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 2530 NE KRESKY AVE STE C, CHEHALIS, WA, 98532-2406, UNITED STATES

Nature of Business

PHYSICIANS OFFICE

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Registered Agent Information

Name Role Address
DAVID A ELLIS Registered Agent 2530 NE KRESKY AVE, CHEHALIS, WA, 98532-2406, UNITED STATES

Key Officers & Management

Name Role Address
DAVID A ELLIS, M.D. Governing Person 100 CEDAR CREST DR, WINLOCK, WA, 98596, UNITED STATES

National Provider Identifier

NPI Number:
1225363351

Authorized Person:

Name:
KIM LEIANN TEITZEL
Role:
BILLING REPRESENTATIVE
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
3607853330

Paycheck Protection Program

Jobs Reported:
7
Initial Approval Amount:
$25,700
Date Approved:
2020-04-30
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$25,700
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$25,938.69
Servicing Lender:
Security State Bank
Use of Proceeds:
Payroll: $25,700
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