DEER PARK FAMILY CARE CLINIC, P.S.

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Company Details

Legal Name:	DEER PARK FAMILY CARE CLINIC, P.S.
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL SERVICE CORPORATION
Category:	DOMESTIC ENTITY
Status:	Active
Formation/ Registration Date:	August 28th 1997
Expiration date:	31 Aug 2025
UBI Number:	601 814 456
ZIP code:	99006
City:	Deer Park
County:	SPOKANE
Home State:	WASHINGTON
Principal Office Street Address:	905 E D ST, DEER PARK, WA, 99006-5167, UNITED STATES
Principal Office Mailing Address:	PO BOX 1529, DEER PARK, WA, 99006-1529, UNITED STATES

Contact Details

E-Mail:	MMORAN@DPFCC.COM
Phone Number:	+1 509-276-5005

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name	Role	Address
EDGAR FIGUEROA	Registered Agent	905 E D ST, DEER PARK, WA, 99006-5167, UNITED STATES

Key Officers & Management

Name	Role
JILLIAN FOGLESONG STABILE	Governing Person
JULIE MORAN	Governing Person
EDGAR FIGUEROA	Governing Person

National Provider Identifier

NPI Number:

1548294150

Link:

View on NPI website

Authorized Person:

Name:

DR. EDGAR A FIGUEROA

Role:

OWNER/PRACTICIONER

Phone:

5092765005

Taxonomy:

Selected Taxonomy:

261QR1300X - Rural Health Clinic/Center

Is Primary:

No

Selected Taxonomy:

207Q00000X - Family Medicine Physician

Is Primary:

Yes

Contacts:

Phone:

+1 509-276-5005

Fax:

5092766785

Form 5500 Series

Employer Identification Number (EIN):

911850482

Plan Year:

2023

Number Of Participants:

57

Plan Name:

401(K)

Sponsor's telephone number:

5092765005

File:

Plan Year:

2022

Number Of Participants:

53

Plan Name:

401(K)

Sponsor's telephone number:

5092765005

File:

Plan Year:

2021

Number Of Participants:

45

Plan Name:

401(K)

Sponsor's telephone number:

5092765005

File:

Plan Year:

2020

Number Of Participants:

41

Plan Name:

401(K)

Sponsor's telephone number:

5092765005

File:

Plan Year:

2019

Number Of Participants:

47

Plan Name:

401(K)

Sponsor's telephone number:

5092765005

File:

Paycheck Protection Program

Jobs Reported:

30

Initial Approval Amount:

$316,800

Date Approved:

2020-04-08

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$316,800

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Female Owned

Veteran:

Non-Veteran

Forgiveness Amount:

$319,672.9

Servicing Lender:

Washington Trust Bank

Use of Proceeds:

Payroll: $316,800

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