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EVERGREEN FAMILY PRACTICE, PLLC

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Company Details

Legal Name: EVERGREEN FAMILY PRACTICE, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: June 21st 2019
Date of Dissolution: February 10th 2023
Expiration date: 30 Jun 2022
UBI Number: 604 477 606
ZIP code: 98506
City: Olympia
County: THURSTON
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 360 LILLY RD NE, STE B, OLYMPIA, WA, 98506-5430, UNITED STATES
Principal Office Mailing Address: Google Maps Logo 360 LILLY RD NE, STE B, LACEY, WA, 98506-5430, UNITED STATES
Supporting healthcare providers fighting with COVID-19: $9,398

Contact Details

E-Mail: MWARNER@EVERGREEN-FAMILY.COM
Phone Number: +1 360-438-3029

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
MICHELLE WARNER Registered Agent 4609 BRIGGS DR SE, 303, OLYMPIA, WA, 98501, UNITED STATES

Key Officers & Management

Name Role Address
MICHELLE WARNER Executor 4229 ROXANNA LOOP SE, LACEY, WA, 98503, UNITED STATES
MICHELLE WARNER Governing Person -

National Provider Identifier

NPI Number:
1932740842

Authorized Person:

Name:
MICHELLE M WARNER
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
3604388585

Paycheck Protection Program

Jobs Reported:
3
Initial Approval Amount:
$13,150
Date Approved:
2020-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$13,150
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$13,236.11
Servicing Lender:
Cross River Bank
Use of Proceeds:
Payroll: $13,150
Jobs Reported:
3
Initial Approval Amount:
$3,858
Date Approved:
2021-04-18
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$3,858
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$3,900.91
Servicing Lender:
Customers Bank
Use of Proceeds:
Payroll: $3,856
Utilities: $1
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