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COMMUNITY VASCULAR WASHINGTON, PLLC

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Company Details

Legal Name: COMMUNITY VASCULAR WASHINGTON, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: August 17th 2022
Expiration date: 31 Aug 2025
UBI Number: 604 960 835
ZIP code: 98902
City: Yakima
County: YAKIMA
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 3902 CREEKSIDE LOOP, SUITE 110, YAKIMA, WA, 98902-4876, UNITED STATES

Contact Details

E-Mail: AP@COMMUNITYVASCULAR.COM
Phone Number: +1 509-215-5946

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role
NATIONAL REGISTERED AGENTS, INC. Registered Agent

Key Officers & Management

Name Role Address
AMR EL-SERGANY Governing Person -
RYAN DIRKS EXECUTOR 2913 5TH AVE NE STE 101, PUYALLUP, WA, 98372-6748, UNITED STATES

National Provider Identifier

NPI Number:
1710603907
Certification Date:
2024-12-31

Authorized Person:

Name:
AMR EL-SERGANY
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
208600000X - Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
5092334585
Fax:
5092450318

Form 5500 Series

Employer Identification Number (EIN):
883802077
Plan Year:
2023
Number Of Participants:
4
Sponsor's telephone number:
Plan Administrator / Signatory:
NICK RICE(Plan administrator)

History

Type Old value New value Date of change
Name change COMMUNITY VASCULAR WASHINGTON, LLC COMMUNITY VASCULAR WASHINGTON, PLLC 2022-11-28
Name change COMMUNITY VASCULAR WASHINGTON, PLLC COMMUNITY VASCULAR WASHINGTON, LLC 2022-11-03
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