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DORIAN HEALTHCARE FOUNDATION

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Company Details

Legal Name: DORIAN HEALTHCARE FOUNDATION
Jurisdiction: WASHINGTON
Entity Type: WA NONPROFIT CORPORATION
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: February 4th 2021
Expiration date: 28 Feb 2026
UBI Number: 604 706 940
ZIP code: 98104
City: Seattle
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 901 BOREN AVE STE 850, SEATTLE, WA, 98104-3301, UNITED STATES

Contact Details

E-Mail: NICOLE@TRIBALMED.COM
Phone Number: +1 206-624-1441

Nature of Business

Any Lawful Purpose, NON-PROFIT MEDICAL CLINIC

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Registered Agent Information

Name Role Address
CHRISTOPHER KEAY Registered Agent 2115 N 30TH ST, SUITE 101, TACOMA, WA, 98403-3396, UNITED STATES

Key Officers & Management

Name Role Address
PETER SHALIT, MD Governing Person -
DONALD GOODMAN Initial Board Of Director 911 1ST AVE W APT 201, SEATTLE, WA, 98119-4728, UNITED STATES
SALLY RAUB Initial Board Of Director 8215 37TH AVE SW, SEATTLE, WA, 98126-3435, UNITED STATES
MARK MCCLARTY Initial Board Of Director 2246 LAKE FOREST AVE, SPRING HILL, FL, 34609-3715, UNITED STATES
PETER SHALIT Incorporator 901 BOREN AVE STE 850, SEATTLE, WA, 98104-3301, UNITED STATES

National Provider Identifier

NPI Number:
1013688217
Certification Date:
2021-09-27

Authorized Person:

Name:
NICOLE LANZ
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

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