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GREAT WEST FAMILY CARE, P.C.

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Company Details

Legal Name: GREAT WEST FAMILY CARE, P.C.
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL SERVICE CORPORATION
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: May 2nd 2002
Date of Dissolution: September 3rd 2013
Expiration date: 31 May 2013
UBI Number: 602 202 713

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Registered Agent Information

Name Role Address
REBECCA L HOFFMAN MD Registered Agent 14508 NE 20TH AVE STE 102, VANCOUVER, WA, 98686, UNITED STATES

Key Officers & Management

Name Role Address
REBECCA HOFFMAN Governing Person 14508 NE 20TH AVE, SUITE 102, VANCOUVER, WA, 98686, UNITED STATES

National Provider Identifier

NPI Number:
1427073840

Authorized Person:

Name:
DR. REBECCA L HOFFMAN
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
No
Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
3605767662
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