EVERGREEN CHILDREN'S CLINIC, PLLC

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Company Details

Legal Name:	EVERGREEN CHILDREN'S CLINIC, PLLC
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Voluntarily Dissolved
Formation/ Registration Date:	September 18th 2001
Date of Dissolution:	August 1st 2023
Expiration date:	30 Sep 2024
UBI Number:	602 150 437
ZIP code:	98403
City:	Tacoma
County:	PIERCE
Home State:	WASHINGTON
Principal Office Street Address:	603 N AINSWORTH AVE, TACOMA, WA, 98403-1121, UNITED STATES

Contact Details

E-Mail:	AESCLEPIOS@HOTMAIL.COM
Phone Number:	+1 253-272-6221

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name	Role	Address
EVERGREEN CHILDREN’S PROPERTY	Registered Agent	603 N AINSWORTH AVE, TACOMA, WA, 98403-1121, UNITED STATES

Key Officers & Management

Name	Role
BARBARA RUSSELL	Governing Person
DON RUSSELL	Governing Person

National Provider Identifier

NPI Number:

1750639704

Link:

View on NPI website

Authorized Person:

Name:

MRS. SUSANNE I ROACH

Role:

OFFICE MANAGER

Phone:

2538482303

Taxonomy:

Selected Taxonomy:

363LP0200X - Pediatric Nurse Practitioner

Is Primary:

Yes

Contacts:

Phone:

+1 253-848-2303

Fax:

2538488956

Form 5500 Series

Employer Identification Number (EIN):

912158392

Plan Year:

2013

Number Of Participants:

19

Sponsor's DBA Name:

PLLC

Sponsor's telephone number:

2538482303

File:

Plan Administrator / Signatory:

BARBARA RUSSELL(Plan administrator)

Plan Year:

2013

Number Of Participants:

16

Plan Name:

401(K)

Sponsor's telephone number:

2538482303

File:

Plan Administrator / Signatory:

DON R. RUSSELL(Plan administrator)

Plan Year:

2012

Number Of Participants:

20

Plan Name:

401(K)

Sponsor's telephone number:

2538482303

File:

Plan Administrator / Signatory:

DON R. RUSSELL(Plan administrator)

Plan Year:

2011

Number Of Participants:

19

Plan Name:

401(K)

Sponsor's telephone number:

2538482303

File:

Plan Administrator / Signatory:

DON R. RUSSELL(Plan administrator)

Plan Year:

2010

Number Of Participants:

15

Plan Name:

401(K)

Sponsor's telephone number:

2538482303

File:

Plan Administrator / Signatory:

TODD HUGHES(Plan administrator)

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EVERGREEN CHILDREN'S PROPERTY, LLC

BARBARA RUSSELL was Governing Person in EVERGREEN CHILDREN'S PROPERTY, LLC.

DON RUSSELL

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DON RUSSELL is Governing Person in DON'S MOBILE WASH, LLC.

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DON RUSSELL was INCORPORATOR in THE SPOKANE OUTREACH CENTER.

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DON RUSSELL was Registered Agent in EVERGREEN CHILDREN'S PROPERTY, LLC.

Related by address

603 N AINSWORTH AVE, TACOMA, WA, 98403-1121, UNITED STATES

EVERGREEN CHILDREN'S PROPERTY, LLC

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