EVERGREEN UROLOGY CONSULTANTS, L.L.C.

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Company Details

Legal Name:	EVERGREEN UROLOGY CONSULTANTS, L.L.C.
Jurisdiction:	WASHINGTON
Entity Type:	WA LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Administratively Dissolved
Formation/ Registration Date:	June 24th 2005
Date of Dissolution:	November 1st 2017
Expiration date:	30 Jun 2017
UBI Number:	602 272 556
ZIP code:	98027
City:	Issaquah
County:	KING
Home State:	WASHINGTON
Principal Office Street Address:	6520 226TH PL SE #205, ISSAQUAH, WA, 98027, UNITED STATES

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Registered Agent Information

Name	Role	Address
EVERGREEN UROLOGY CONSULTANTS	Registered Agent	6520 226TH PL SE #205, ISSAQUAH, WA, 98027-0000, UNITED STATES

Key Officers & Management

Name	Role	Address
LORA PLASKON	Governing Person	6520 226TH PL SE #205, ISSAQUAH, WA, 98027, UNITED STATES
MIA SWARTZ	Governing Person	6520 226TH PL SE #205, ISSAQUAH, WA, 98027, UNITED STATES
JULIE LACOMBE	Governing Person	6520 226TH PL SE #205, ISSAQUAH, WA, 98027, UNITED STATES

National Provider Identifier

NPI Number:

1013004803

Link:

View on NPI website

Authorized Person:

Name:

LORA PLASKON

Role:

OWNER

Phone:

4253928611

Taxonomy:

Selected Taxonomy:

174400000X - Specialist

Is Primary:

Yes

Contacts:

Phone:

+1 425-392-8611

Fax:

4253929012

Form 5500 Series

Employer Identification Number (EIN):

721551360

Plan Year:

2015

Number Of Participants:

17

Sponsor's telephone number:

4253928611

File:

Plan Administrator / Signatory:

LORA PLASKON(Plan administrator)

Plan Year:

2014

Number Of Participants:

19

Sponsor's telephone number:

4253928611

File:

Plan Administrator / Signatory:

LORA PLASKON(Plan administrator)

Plan Year:

2013

Number Of Participants:

17

Sponsor's telephone number:

4253928611

File:

Plan Administrator / Signatory:

AMY SCHLIGHT(Plan administrator)

Plan Year:

2012

Number Of Participants:

13

Sponsor's telephone number:

4253928611

File:

Plan Administrator / Signatory:

EVERGREEN UROLOGY CONSULTANTS(Plan administrator)

Plan Year:

2011

Number Of Participants:

13

Sponsor's telephone number:

4253928611

File:

Plan Administrator / Signatory:

EVERGREEN UROLOGY CONSULTANTS(Plan administrator)

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