JACKSON VISION CLINIC INC.

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Company Details

Legal Name:	JACKSON VISION CLINIC INC.
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFIT CORPORATION
Category:	DOMESTIC ENTITY
Status:	Active
Formation/ Registration Date:	June 11th 2002
Expiration date:	30 Jun 2026
UBI Number:	602 212 109
ZIP code:	98144
City:	Seattle
County:	KING
Home State:	WASHINGTON
Principal Office Street Address:	3324 RAINIER AVE S, SEATTLE, WA, 98144-6034, UNITED STATES
Supporting healthcare providers fighting with COVID-19:	$19,512

Contact Details

E-Mail:	SAMANTHA@OPTOMETRYMEDICALGROUP.COM
Phone Number:	+1 206-322-6915

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name	Role
JACKSON VISION CLINIC INC.	Registered Agent

Key Officers & Management

Name	Role
HUY HOANG	Governing Person

National Provider Identifier

NPI Number:

1215121140

Certification Date:

2024-03-28

Link:

View on NPI website

Authorized Person:

Name:

MRS. SAMANTHA HOANG

Role:

DIRECTOR

Phone:

2063952266

Taxonomy:

Selected Taxonomy:

152W00000X - Optometrist

Is Primary:

Yes

Contacts:

Phone:

+1 206-322-6915

Fax:

2063952315

Form 5500 Series

Employer Identification Number (EIN):

010714472

Plan Year:

2023

Number Of Participants:

8

Plan Name:

401(K)

Sponsor's telephone number:

2063226915

File:

Plan Administrator / Signatory:

SAMANTHA HOANG(Plan administrator)

Plan Year:

2022

Number Of Participants:

8

Plan Name:

401(K)

Sponsor's telephone number:

2063952266

File:

Plan Administrator / Signatory:

HUY HOANG(Plan administrator)

Plan Year:

2021

Number Of Participants:

8

Sponsor's telephone number:

2063952266

File:

Plan Administrator / Signatory:

HUY HOANG(Plan administrator)

Plan Year:

2020

Number Of Participants:

8

Sponsor's telephone number:

2063952266

File:

Plan Administrator / Signatory:

HUY HOANG(Plan administrator) HUY HOANG(Employer/plan sponsor)

Plan Year:

2019

Number Of Participants:

8

Sponsor's telephone number:

2063952266

File:

Plan Administrator / Signatory:

HUY HOANG(Plan administrator) HUY HOANG(Employer/plan sponsor)

Paycheck Protection Program

Jobs Reported:

28

Initial Approval Amount:

$147,225

Date Approved:

2020-05-01

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$147,225

Race:

Asian

Ethnicity:

Not Hispanic or Latino

Gender:

Male Owned

Veteran:

Non-Veteran

Forgiveness Amount:

$149,237.75

Servicing Lender:

Bank of America, National Association

Use of Proceeds:

Payroll: $147,225

Jobs Reported:

28

Initial Approval Amount:

$147,225

Date Approved:

2021-01-31

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$147,225

Race:

Asian

Ethnicity:

Not Hispanic or Latino

Gender:

Male Owned

Veteran:

Non-Veteran

Forgiveness Amount:

$149,677.41

Servicing Lender:

Bank of America, National Association

Use of Proceeds:

Payroll: $147,219
Utilities: $1

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