ISSAQUAH OBSTETRICS AND GYNECOLOGY PLLC

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Company Details

Legal Name:	ISSAQUAH OBSTETRICS AND GYNECOLOGY PLLC
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Administratively Dissolved
Formation/ Registration Date:	August 20th 2004
Date of Dissolution:	February 9th 2023
Expiration date:	31 Aug 2022
UBI Number:	602 422 751
ZIP code:	98027
City:	Issaquah
County:	KING
Home State:	WASHINGTON
Principal Office Street Address:	6520 226TH PL SE STE 120, ISSAQUAH, WA, 98027-7371, UNITED STATES
Supporting healthcare providers fighting with COVID-19:	$895

Contact Details

E-Mail:	PADMA@ISSAQUAHOBGYN.COM
Phone Number:	+1 425-391-8886

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name	Role	Address
ISSAQUAH OBSTETRICS & GYNECOLOGY, PLLC	Registered Agent	6520 226TH PL SE STE 120, ISSAQUAH, WA, 98027-7371, UNITED STATES

Key Officers & Management

Name	Role	Address
ELISABETH EVANS	Governing Person	-
SANDRA GALLAGHER-ALFORD	EXECUTOR	1501 FOURTH AVE #2600, SEATTLE, WA, 98101, UNITED STATES

National Provider Identifier

NPI Number:

1073581807

Link:

View on NPI website

Authorized Person:

Name:

MS. MARGARET A HARRIS

Role:

CLINIC MANAGER

Phone:

4253918886

Taxonomy:

Selected Taxonomy:

207V00000X - Obstetrics & Gynecology Physician

Is Primary:

Yes

Contacts:

Phone:

+1 425-391-8886

Fax:

4253941087

Form 5500 Series

Employer Identification Number (EIN):

562477630

Plan Year:

2022

Number Of Participants:

6

Plan Name:

401(K)

Sponsor's telephone number:

4253918886

File:

Plan Administrator / Signatory:

PADMA PANCHALAVARAPU(Plan administrator) PADMA PANCHALAVARAPU(Employer/plan sponsor)

Plan Year:

2021

Number Of Participants:

6

Plan Name:

401(K)

Sponsor's telephone number:

4253918886

File:

Plan Administrator / Signatory:

PADMA PANCHALAVARAPU(Plan administrator) PADMA PANCHALAVARAPU(Employer/plan sponsor)

Plan Year:

2020

Number Of Participants:

7

Plan Name:

401(K)

Sponsor's telephone number:

4253918886

File:

Plan Administrator / Signatory:

PADMA PANCHALAVARAPU(Plan administrator) PADMA PANCHALAVARAPU(Employer/plan sponsor)

Plan Year:

2019

Number Of Participants:

8

Plan Name:

401(K)

Sponsor's telephone number:

4253918886

File:

Plan Administrator / Signatory:

PADMA PANCHALAVARAPU(Plan administrator) PADMA PANCHALAVARAPU(Employer/plan sponsor)

Plan Year:

2018

Number Of Participants:

7

Plan Name:

401(K)

Sponsor's telephone number:

4253918886

File:

Plan Administrator / Signatory:

PADMA PANCHALAVARAPU(Plan administrator) PADMA PANCHALAVARAPU(Employer/plan sponsor)

Paycheck Protection Program

Jobs Reported:

2

Initial Approval Amount:

$45,562

Date Approved:

2021-01-27

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$45,562

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$46,017.62

Servicing Lender:

Umpqua Bank

Use of Proceeds:

Payroll: $45,561

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