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CHESNUT INSTITUTE OF COSMETIC & RECONSTRUCTIVE SURGERY, PLLC

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Company Details

Legal Name: CHESNUT INSTITUTE OF COSMETIC & RECONSTRUCTIVE SURGERY, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: September 6th 2016
Expiration date: 30 Sep 2025
UBI Number: 604 035 128
ZIP code: 99202
City: Spokane
County: SPOKANE
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 510 S COWLEY ST, SPOKANE, WA, 99202-1332, UNITED STATES
Supporting healthcare providers fighting with COVID-19: $103,616

Contact Details

E-Mail: ADMIN@CLINIC5C.COM
Phone Number: +1 208-771-3898

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role
C T CORPORATION SYSTEM Registered Agent

Key Officers & Management

Name Role
CAMERON CHESNUT Governing Person

National Provider Identifier

NPI Number:
1073146734
Certification Date:
2020-03-18
Link:
View on NPI website

Authorized Person:

Name:
MR. GRAYLING LOVE II
Role:
C.O.O.
Phone:
6782162718

Taxonomy:

Selected Taxonomy:
208200000X - Plastic Surgery Physician
Is Primary:
No
Selected Taxonomy:
2082S0099X - Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
Is Primary:
No
Selected Taxonomy:
2086S0122X - Plastic and Reconstructive Surgery Physician
Is Primary:
No
Selected Taxonomy:
207ND0101X - MOHS-Micrographic Surgery Physician
Is Primary:
No
Selected Taxonomy:
207NS0135X - Procedural Dermatology Physician
Is Primary:
No
Selected Taxonomy:
207Y00000X - Otolaryngology Physician
Is Primary:
No
Selected Taxonomy:
207YX0905X - Otolaryngology/Facial Plastic Surgery Physician
Is Primary:
No
Selected Taxonomy:
207YS0123X - Facial Plastic Surgery Physician
Is Primary:
No
Selected Taxonomy:
207YX0007X - Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Is Primary:
No
Selected Taxonomy:
261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary:
No
Selected Taxonomy:
207N00000X - Dermatology Physician
Is Primary:
Yes

Contacts:

Phone:
+1 509-252-1299

Form 5500 Series

Employer Identification Number (EIN):
821592877
Plan Year:
2023
Number Of Participants:
24
Plan Name:
CASH BALANCE
Sponsor's telephone number:
6782162718
File:
View File
Plan Year:
2022
Number Of Participants:
15
Plan Name:
CASH BALANCE
Sponsor's telephone number:
6782162718
File:
View File
Plan Year:
2020
Number Of Participants:
0
Plan Name:
401(K)
Sponsor's telephone number:
6782162718
File:
View File
Plan Administrator / Signatory:
GARYLING LOVE II(Plan administrator)

Paycheck Protection Program

Jobs Reported:
13
Initial Approval Amount:
$180,900
Date Approved:
2020-04-08
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$180,900
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$183,556.5
Servicing Lender:
Washington Trust Bank
Use of Proceeds:
Payroll: $180,900

Related by address

510 S COWLEY ST, SPOKANE, WA, 99202-1332, UNITED STATES

CLINIC 5C, PLLC
WA PROFESSIONAL LIMITED LIABILITY COMPANY - Active
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