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HEALTHSOURCE OF MOSES LAKE, INC.
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Company Details
Legal Name:
HEALTHSOURCE OF MOSES LAKE, INC.
Jurisdiction:
WASHINGTON
Entity Type:
WA PROFIT CORPORATION
Category:
DOMESTIC ENTITY
Status:
Voluntarily Dissolved
Formation/ Registration Date:
December 6th 2013
Date of Dissolution:
August 17th 2018
Expiration date:
31 Dec 2018
UBI Number:
603 362 334
ZIP code:
98837
City:
Moses Lake
County:
GRANT
Home State:
WASHINGTON
Principal Office Street Address:
420 W THIRD AVE, MOSES LAKE, WA, 98837, UNITED STATES
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Registered Agent Information
Name
Role
Address
GREGG JONES
Registered Agent
420 W THIRD AVE, MOSES LAKE, WA, 98837-0000, UNITED STATES
Key Officers & Management
Name
Role
GREGG JONES
Governing Person
National Provider Identifier
NPI Number:
1003212895
Link:
View on NPI website
Authorized Person:
Name:
DR. GREGG MOYLE JONES
Role:
PRESIDENT
Phone:
5097650638
Taxonomy:
Selected Taxonomy:
261Q00000X - Clinic/Center
Is Primary:
Yes
Contacts:
Phone:
+1 509-765-0638
Fax:
5097653891
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