DAVID L. LUKENS, D.O., P.S.

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Company Details

Legal Name:	DAVID L. LUKENS, D.O., P.S.
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL SERVICE CORPORATION
Category:	DOMESTIC ENTITY
Status:	Administratively Dissolved
Formation/ Registration Date:	May 26th 1976
Date of Dissolution:	October 2nd 2017
Expiration date:	31 May 2017
UBI Number:	600 197 457
Supporting healthcare providers fighting with COVID-19:	$5,153

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Registered Agent Information

Name	Role	Address
DAVID L LUKENS D O	Registered Agent	1802 S UNION AVE STE 200, TACOMA, WA, 98405, UNITED STATES

Key Officers & Management

Name	Role
ROSEMARY LUKENS	Governing Person
DAVID LUKENS	Governing Person

National Provider Identifier

NPI Number:

1265765309

Link:

View on NPI website

Authorized Person:

Name:

DR. DAVID LEE LUKENS

Role:

PRESIDENT

Phone:

2535727101

Taxonomy:

Selected Taxonomy:

208100000X - Physical Medicine & Rehabilitation Physician

Is Primary:

No

Selected Taxonomy:

207Q00000X - Family Medicine Physician

Is Primary:

Yes

Contacts:

Phone:

+1 253-572-7101

Fax:

2535729461

Form 5500 Series

Employer Identification Number (EIN):

910962933

Plan Year:

2012

Number Of Participants:

2

Plan Name:

401(K)

Sponsor's telephone number:

2535727101

File:

Plan Administrator / Signatory:

DAVID L. LUKENS(Plan administrator)

Plan Year:

2011

Number Of Participants:

5

Plan Name:

401(K)

Sponsor's telephone number:

2535727101

File:

Plan Administrator / Signatory:

DAVID LUKENS(Plan administrator)

Plan Year:

2010

Number Of Participants:

4

Plan Name:

401(K)

Sponsor's telephone number:

2535727101

File:

Plan Administrator / Signatory:

DAVID LUKENS(Plan administrator) DAVID LUKENS(Employer/plan sponsor)

Plan Year:

2009

Number Of Participants:

4

Plan Name:

401(K)

Sponsor's telephone number:

2535727101

File:

Plan Administrator / Signatory:

DAVID LUKENS(Plan administrator) DAVID LUKENS(Employer/plan sponsor)

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