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ISLA COMMUNITY CLINIC, NP PC

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Company Details

Legal Name: ISLA COMMUNITY CLINIC, NP PC
Jurisdiction: WASHINGTON
Entity Type: WA NONPROFIT PROFESSIONAL SERVICE CORPORATION
Category: DOMESTIC ENTITY
Status: Voluntarily Dissolved
Formation/ Registration Date: January 19th 2023
Date of Dissolution: September 24th 2024
Expiration date: 31 Jan 2025
UBI Number: 605 017 745
ZIP code: 98236
City: Clinton
County: ISLAND
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 3060 SWEDE HILL RD, CLINTON, WA, 98236-8808, UNITED STATES

Contact Details

E-Mail: SHAWNSMORRIS@GMAIL.COM

Nature of Business

Benevolent, HEALTHCARE, NOT CURRENTLY PROVIDING SERVICES PLANNED LAUNCH IN SPRING OF 2024

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Registered Agent Information

Name Role Address
SHAWN MORRIS Registered Agent 3060 SWEDE HILL RD, CLINTON, WA, 98236-8808, UNITED STATES

Key Officers & Management

Name Role Address
SHAWN MORRIS Governing Person 610 5TH ST, MUKILTEO, WA, 98275-1504, UNITED STATES
SUSAN MILAN Initial Board Of Director 3955 GOLDFINCH LN, CLINTON, WA, 98236-8615, UNITED STATES
TERESA MURPHY, MD Initial Board Of Director 5486 HARBOR AVE, FREELAND, WA, 98249-3002, UNITED STATES
MICHAEL BLOOM Initial Board Of Director 3955 GOLDFINCH LN, CLINTON, WA, 98236-8615, UNITED STATES
SHAWN MORRIS, ND Initial Board Of Director 3060 SWEDE HILL RD, CLINTON, WA, 98236-8808, UNITED STATES
SHAWN MORRIS Incorporator 3060 SWEDE HILL RD, CLINTON, WA, 98236-8808, UNITED STATES

National Provider Identifier

NPI Number:
1043919749
Certification Date:
2023-03-01

Authorized Person:

Name:
SHAWN MORRIS
Role:
MEDICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
175F00000X - Naturopath
Is Primary:
Yes

Contacts:

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