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ESSENTIAL PSYCHIATRY, PLLC

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Company Details

Legal Name: ESSENTIAL PSYCHIATRY, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: November 23rd 2020
Expiration date: 30 Nov 2025
UBI Number: 604 676 065
ZIP code: 99022
City: Medical Lake
County: SPOKANE
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 731 N STANLEY ST, MEDICAL LAKE, WA, 99022-8940, UNITED STATES

Contact Details

E-Mail: CANDIE@ESSENTIAL-PSYCHIATRY.COM
Phone Number: +1 509-299-6900

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
CANDIE WELLWOOD Registered Agent 731 N STANLEY ST, MEDICAL LAKE, WA, 99022-8940, UNITED STATES

Key Officers & Management

Name Role Address
CANDIE WELLWOOD Executor 9908 S SHERMAN RD, SPOKANE, WA, 99224-9811, UNITED STATES
CANDIE WELLWOOD Governing Person 9908 S SHERMAN RD, SPOKANE, WA, 99224-9811, UNITED STATES

National Provider Identifier

NPI Number:
1922771682
Certification Date:
2021-07-28

Authorized Person:

Name:
CANDIE M. WELLWOOD
Role:
OWNER/PRACTITIONER
Phone:

Taxonomy:

Selected Taxonomy:
363LP0808X - Psychiatric/Mental Health Nurse Practitioner
Is Primary:
Yes

Contacts:

Fax:
5093512818
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