GREENLAKE SPORTS PHYSICAL THERAPY, INC.

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Company Details

Legal Name:	GREENLAKE SPORTS PHYSICAL THERAPY, INC.
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFIT CORPORATION
Category:	DOMESTIC ENTITY
Status:	Voluntarily Dissolved
Formation/ Registration Date:	February 6th 2004
Expiration date:	28 Feb 2025
UBI Number:	602 362 003
ZIP code:	98584
City:	Shelton
County:	MASON
Home State:	WASHINGTON
Principal Office Street Address:	201 E FERRY LOOP RD, SHELTON, WA, 98584-8411, UNITED STATES

Contact Details

E-Mail:	FROGSFLY@COMCAST.NET
Phone Number:	+1 206-852-0270

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name	Role	Address
GREENLAKE SPORTS PHYSICAL THERAPY INC	Registered Agent	408 NE 72ND ST, SEATTLE, WA, 98115-5409, UNITED STATES

Key Officers & Management

Name	Role
BART SIMONS	Governing Person
PEGGY SMITH	Governing Person

National Provider Identifier

NPI Number:

1801920566

Link:

View on NPI website

Authorized Person:

Name:

MR. BART D SIMONS

Role:

OWNERPRESIDENT

Phone:

2065245115

Taxonomy:

Selected Taxonomy:

225100000X - Physical Therapist

Is Primary:

Yes

Contacts:

Phone:

+1 206-524-5115

Fax:

2065242456

Form 5500 Series

Employer Identification Number (EIN):

200671715

Plan Year:

2023

Number Of Participants:

12

Plan Name:

401(K)

Sponsor's telephone number:

2065245115

File:

Plan Year:

2023

Number Of Participants:

13

Plan Name:

401(K)

Sponsor's telephone number:

2065245115

File:

Plan Year:

2022

Number Of Participants:

9

Plan Name:

401(K)

Sponsor's telephone number:

2065245115

File:

Plan Year:

2021

Number Of Participants:

9

Plan Name:

401(K)

Sponsor's telephone number:

2065245115

File:

Plan Year:

2020

Number Of Participants:

9

Plan Name:

401(K)

Sponsor's telephone number:

2065245115

File:

Paycheck Protection Program

Jobs Reported:

12

Initial Approval Amount:

$110,700

Date Approved:

2020-04-13

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$110,700

Race:

White

Ethnicity:

Not Hispanic or Latino

Gender:

Female Owned

Veteran:

Non-Veteran

Forgiveness Amount:

$112,004.14

Servicing Lender:

HomeStreet Bank

Use of Proceeds:

Payroll: $110,700

Related by address

201 E FERRY LOOP RD, SHELTON, WA, 98584-8411, UNITED STATES

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