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EASTSIDE PREMIER MEDICINE, PLLC

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Company Details

Legal Name: EASTSIDE PREMIER MEDICINE, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: July 14th 2005
Date of Dissolution: December 3rd 2024
Expiration date: 31 Jul 2024
UBI Number: 602 521 317
ZIP code: 98004
City: Bellevue
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 2950 NORTHUP WAY STE 210, BELLEVUE, WA, 98004, UNITED STATES
Principal Office Mailing Address: Google Maps Logo 2950 NORTHUP WAY STE 210, BELLEVUE, WA, 98004-1406, UNITED STATES
Supporting healthcare providers fighting with COVID-19: $13,786

Contact Details

E-Mail: DRDONLAN@EASTSIDEPREMIERMD.COM
Phone Number: +1 425-284-3377

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
DAN J DONLAN Registered Agent 19110 NE 155TH ST, WOODINVILLE, WA, 98072-9363, UNITED STATES

Key Officers & Management

Name Role Address
STACEY DONLAN Governing Person 2950 NORTHUP WAY #210, BELLEVUE, WA, 98004, UNITED STATES
STACEY DONLAN EXECUTOR 19110 NE 155TH ST, WOODINVILLE, WA, 98072, UNITED STATES

National Provider Identifier

NPI Number:
1518025618

Authorized Person:

Name:
STACEY S. DONLAN
Role:
PHYSICIAN
Phone:

Taxonomy:

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

Contacts:

Fax:
4258271040
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