EVERGREEN WOMEN'S CARE, PLLC

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Company Details

Legal Name:	EVERGREEN WOMEN'S CARE, PLLC
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Administratively Dissolved
Formation/ Registration Date:	February 15th 2005
Date of Dissolution:	October 8th 2014
Expiration date:	28 Feb 2015
UBI Number:	602 473 985
ZIP code:	98034
City:	Kirkland
County:	KING
Home State:	WASHINGTON
Principal Office Street Address:	12303 NE 130TH LN STE 420, KIRKLAND, WA, 98034, UNITED STATES

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Registered Agent Information

Name	Role	Address
SUSAN J.TEMPLETON	Registered Agent	12303 NE 30TH LN STE 420, KIRKLAND, WA, 98034, UNITED STATES

Key Officers & Management

Name	Role	Address
PATRICK MORELL	Governing Person	12303 NE 130TH LN STE 420, KIRKLAND, WA, 98034, UNITED STATES
DEBRA STEMMERMAN	Governing Person	12303 NE 130TH LN STE 420, KIRKLAND, WA, 98034, UNITED STATES
DAWN RUSSELL	Governing Person	12303 NE 130TH LN STE 420, KIRKLAND, WA, 98034, UNITED STATES
STEPHEN HYDE	Governing Person	12303 NE 130TH LN STE 420, KIRKLAND, WA, 98034, UNITED STATES
DAWN RUSSELL	EXECUTOR	12303 NE 130TH LN STE 420, KIRKLAND, WA, 98034, UNITED STATES

National Provider Identifier

NPI Number:

1639226574

Link:

View on NPI website

Authorized Person:

Name:

MS. SUSAN J TEMPLETON

Role:

CLINIC ADMINISTRATOR

Phone:

4252501255

Taxonomy:

Selected Taxonomy:

207VX0000X - Obstetrics Physician

Is Primary:

Yes

Contacts:

Phone:

+1 425-899-6400

Fax:

4258994490

Form 5500 Series

Employer Identification Number (EIN):

202373232

Plan Year:

2013

Number Of Participants:

55

Plan Name:

401(K)

Sponsor's telephone number:

4258996400

File:

Plan Administrator / Signatory:

DEBRA STEMMERMAN, MD(Plan administrator)

Plan Year:

2013

Number Of Participants:

50

Plan Name:

401(K)

Sponsor's telephone number:

4258996400

File:

Plan Administrator / Signatory:

DEBRA M STEMMERMAN(Plan administrator)

Plan Year:

2012

Number Of Participants:

59

Plan Name:

401(K)

Sponsor's telephone number:

4258996400

File:

Plan Administrator / Signatory:

DEBRA STEMERMAN, MD(Plan administrator)

Plan Year:

2011

Number Of Participants:

60

Plan Name:

401(K)

Sponsor's telephone number:

4258996400

File:

Plan Administrator / Signatory:

DEBRA STEMERMAN, MD(Plan administrator)

Plan Year:

2011

Number Of Participants:

60

Plan Name:

401(K)

Sponsor's telephone number:

4258996400

Plan Administrator / Signatory:

DEBRA STEMERMAN, MD(Plan administrator)

OSHA's Inspections within Industry

Inspection Summary

Date:

1991-05-23

Type:

Planned

Address:

12034 NE 130TH LANE SUITE 201, KIRKLAND, WA, 98034

Safety Health:

Health

Scope:

Complete

Inspection Link:

View Inspection data on OSHA website

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