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HRT EVERGREEN PC

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Company Details

Legal Name: HRT EVERGREEN PC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL SERVICE CORPORATION
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: February 21st 2025
Expiration date: 28 Feb 2026
UBI Number: 605 740 255
ZIP code: 99206
City: Spokane
County: SPOKANE
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 11917 E BROADWAY AVE, SPOKANE VLY, WA, 99206-6011, UNITED STATES
Principal Office Mailing Address: Google Maps Logo 14358 N FRANK LLOYD WRIGHT BLVD STE 4, SCOTTSDALE, AZ, 85260-8845, UNITED STATES

Contact Details

E-Mail: SKAY@AGELESSMENSHEALTH.COM
Phone Number: +1 623-217-3070

Nature of Business

Professional, Scientific & Technical Services, Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role
NATIONAL REGISTERED AGENTS, INC. Registered Agent

Key Officers & Management

Name Role Address
SUSAN KAY Governing Person -
HANNA M. MITIAS, M.D. INCORPORATOR 206 OXFORD RD, NEW ALBANY, MS, 38652-3115, UNITED STATES

National Provider Identifier

NPI Number:
1730986035
Certification Date:
2025-02-25

Authorized Person:

Name:
AMANDA WILKINSON
Role:
BUSINESS OPERATIONS DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

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