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FOUR CREEKS ANESTHESIA SERVICES LLC

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Company Details

Legal Name: FOUR CREEKS ANESTHESIA SERVICES LLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: July 14th 2008
Date of Dissolution: November 3rd 2014
Expiration date: 31 Jul 2014
UBI Number: 602 821 701
ZIP code: 98027
City: Issaquah
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 13607 229TH DRIVE SE, ISSAQUAH, WA, 98027, UNITED STATES

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Registered Agent Information

Name Role Address
LOREN COPELAND Registered Agent 13607 229TH DRIVE SE, ISSAQUAH, WA, 98027, UNITED STATES

Key Officers & Management

Name Role Address
LOREN COPELAND Governing Person 13607 229TH DRIVE SE, ISSAQUAH, WA, 98027, UNITED STATES
RACHELL COPELAND Governing Person 13607 229TH DRIVE SE, ISSAQUAH, WA, 98027, UNITED STATES
DIANNE HAMMOND EXECUTOR 2633 SW BRANT, NEWPORT, OR, 97365, UNITED STATES

National Provider Identifier

NPI Number:
1982832333

Authorized Person:

Name:
LOREN K COPELAND
Role:
PROVIDER/OWNER
Phone:

Taxonomy:

Selected Taxonomy:
367500000X - Certified Registered Nurse Anesthetist
Is Primary:
Yes

Contacts:

Fax:
2533656299
Fax:
2069859806
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