JARED BLOXHAM, PLLC.

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Company Details

Legal Name:	JARED BLOXHAM, PLLC.
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Active
Formation/ Registration Date:	May 22nd 2019
Expiration date:	31 May 2026
UBI Number:	604 464 222
ZIP code:	99352
City:	Richland
County:	BENTON
Home State:	WASHINGTON
Principal Office Street Address:	1363 COLUMBIA PARK TRL STE 101, RICHLAND, WA, 99352-4770, UNITED STATES
Principal Office Mailing Address:	1363 COLUMBIA PARK TRL STE 101, KENNEWICK, WA, 99336, UNITED STATES

Contact Details

E-Mail:

MARKETING@COLUMBIATMJANDPAIN.COM

Nature of Business

Any Lawful Purpose

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Registered Agent Information

Name	Role
LEAVY SCHULTZ DAVIS, P.S.	Registered Agent

Key Officers & Management

Name	Role	Address
BRIAN DOYLE	Executor	2415 W FALLS AVE, KENNEWICK, WA, 99336-3068, UNITED STATES
JARED BLOXHAM	Governing Person	-

National Provider Identifier

NPI Number:

1194344614

Certification Date:

2025-03-11

Link:

View on NPI website

Authorized Person:

Name:

DR. JARED V BLOXHAM

Role:

OWNER

Phone:

5093668607

Taxonomy:

Selected Taxonomy:

332B00000X - Durable Medical Equipment & Medical Supplies

Is Primary:

No

Selected Taxonomy:

1223X2210X - Orofacial Pain Dentist

Is Primary:

Yes

Contacts:

Phone:

+1 509-578-5770

Form 5500 Series

Employer Identification Number (EIN):

841931277

Plan Year:

2024

Number Of Participants:

10

Plan Name:

401(K)

Sponsor's telephone number:

5095785770

File:

Plan Administrator / Signatory:

QIAN LIU(Plan administrator)

Plan Year:

2023

Number Of Participants:

8

Plan Name:

401(K)

Sponsor's telephone number:

5095785770

File:

Plan Administrator / Signatory:

QIAN LIU(Plan administrator)

Plan Year:

2022

Number Of Participants:

6

Plan Name:

401(K)

Sponsor's telephone number:

5095785770

File:

Plan Administrator / Signatory:

CHRISTINE RIMER(Plan administrator)

Plan Year:

2021

Number Of Participants:

0

Plan Name:

401(K)

Sponsor's telephone number:

5095785770

File:

Plan Administrator / Signatory:

CHRISTINE RIMER(Plan administrator)

Paycheck Protection Program

Jobs Reported:

4

Initial Approval Amount:

$55,267

Date Approved:

2020-04-28

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$55,267

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$55,786.36

Servicing Lender:

Umpqua Bank

Use of Proceeds:

Payroll: $55,267

Jobs Reported:

5

Initial Approval Amount:

$33,172

Date Approved:

2021-01-27

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$33,172

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$33,340.13

Servicing Lender:

Umpqua Bank

Use of Proceeds:

Payroll: $33,168

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