ENT-FACIAL PLASTIC SURGERY ASSOCIATES, P.L.L.C.

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Company Details

Legal Name:	ENT-FACIAL PLASTIC SURGERY ASSOCIATES, P.L.L.C.
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Administratively Dissolved
Formation/ Registration Date:	September 27th 2004
Date of Dissolution:	January 2nd 2015
Expiration date:	30 Sep 2014
UBI Number:	602 432 623
ZIP code:	98902
City:	Yakima
County:	YAKIMA
Home State:	WASHINGTON
Principal Office Street Address:	3999 ENGLEWOOD AVE #201, YAKIMA, WA, 98902, UNITED STATES

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Registered Agent Information

Name	Role	Address
PAUL M LARSON	Registered Agent	105 N 3RD ST, YAKIMA, WA, 98907, UNITED STATES

Key Officers & Management

Name	Role	Address
CAROL HYSMAN	Governing Person	-
PALMER WRIGHT	Governing Person	-
PAUL M LARSON	EXECUTOR	105 N 3RD ST, PO BOX 550, YAKIMA, WA, 98907, UNITED STATES

National Provider Identifier

NPI Number:

1700963782

Link:

View on NPI website

Authorized Person:

Name:

PALMER P WRIGHT

Role:

OWNER

Phone:

5094535300

Taxonomy:

Selected Taxonomy:

207YX0905X - Otolaryngology/Facial Plastic Surgery Physician

Is Primary:

Yes

Contacts:

Phone:

+1 509-453-5300

Fax:

5094531200

Form 5500 Series

Employer Identification Number (EIN):

202932741

Plan Year:

2013

Number Of Participants:

12

Sponsor's telephone number:

5094535300

File:

Plan Administrator / Signatory:

PALMER WRIGHT, DO(Plan administrator)

Plan Year:

2012

Number Of Participants:

11

Sponsor's telephone number:

5094535300

File:

Plan Administrator / Signatory:

PALMER WRIGHT, DO(Plan administrator)

Plan Year:

2011

Number Of Participants:

12

Sponsor's telephone number:

5094535300

File:

Plan Administrator / Signatory:

PALMER WRIGHT, DO(Plan administrator)

Plan Year:

2010

Number Of Participants:

11

Sponsor's telephone number:

5094535300

File:

Plan Administrator / Signatory:

PALMER WRIGHT DO(Plan administrator)

Plan Year:

2009

Number Of Participants:

11

Sponsor's telephone number:

5094535300

File:

Plan Administrator / Signatory:

PALMER WRIGHT DO(Plan administrator)

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