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GALLANT LION MEDICAL LLC

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Company Details

Legal Name: GALLANT LION MEDICAL LLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: May 4th 2020
Expiration date: 31 May 2026
UBI Number: 604 604 796
ZIP code: 98225
City: Bellingham
County: WHATCOM
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 500 BIRCHWOOD AVE STE A, BELLINGHAM, WA, 98225-1703, UNITED STATES

Contact Details

E-Mail: ROBINJACKSON2004@YAHOO.COM
Phone Number: +1 916-296-7909

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role
GALLANT LION MEDICAL LLC Registered Agent

Key Officers & Management

Name Role Address
KORRIN JACKSON Executor 500 BIRCHWOOD AVE SUITE A, BELLINGHAM, WA, 98225-1703, UNITED STATES
ROBIN JACKSON Executor 500 BIRCHWOOD AVE STE A, BELLINGHAM, WA, 98225-1703, UNITED STATES
ROBIN JACKSON Governing Person 500 BIRCHWOOD AVE STE A, BELLINGHAM, WA, 98225, UNITED STATES

National Provider Identifier

NPI Number:
1114548104
Certification Date:
2023-10-02

Authorized Person:

Name:
ROBIN JACKSON
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
Yes

Contacts:

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