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EVERGREEN WASHINGTON HEALTHCARE CENTRALIA, L.L.C.

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Company Details

Legal Name: EVERGREEN WASHINGTON HEALTHCARE CENTRALIA, L.L.C.
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Inactive
Formation/ Registration Date: January 29th 1997
Date of Dissolution: February 11th 2011
Expiration date: 31 Jan 2011
UBI Number: 601 765 279

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Registered Agent Information

Name Role Address
PATRICIAGROTH Registered Agent 4601 NE 77TH AVE STE 300, VANCOUVER, WA, 98662, UNITED STATES

Key Officers & Management

Name Role Address
ANNE NIPP Governing Person 4601 NE 77TH AVE STE 300, VANCOUVER, WA, 98662-6736, UNITED STATES
JAN TIETJEN Governing Person 4601 NE 77TH AVE STE 300, VANCOUVER, WA, 98662-6736, UNITED STATES

National Provider Identifier

NPI Number:
1942295993

Authorized Person:

Name:
DALE L. PATTERSON
Role:
MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
314000000X - Skilled Nursing Facility
Is Primary:
Yes

Contacts:

Fax:
3608825793
Fax:
3603302901
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