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KETAMINE SEATTLE PLLC

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Company Details

Legal Name: KETAMINE SEATTLE PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: February 21st 2025
Expiration date: 28 Feb 2026
UBI Number: 605 745 134
ZIP code: 98103
City: Seattle
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 3800 AURORA AVE N STE 360, SEATTLE, WA, 98103-8721, UNITED STATES

Contact Details

E-Mail: IAMDEWFLY@YAHOO.COM

Nature of Business

Other Services, PSYCHIATRY PRACTICE

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Registered Agent Information

Name Role
REGISTERED AGENTS INC Registered Agent

Key Officers & Management

Name Role Address
DIANE WATSON Executor 12 NE FREMONT ST UNIT 3W, PORTLAND, OR, 97212-1166, UNITED STATES
DIANE WATSON Governing Person -

National Provider Identifier

NPI Number:
1891588729
Certification Date:
2025-05-23

Authorized Person:

Name:
DIANE ELIZABETH WATSON
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
363LP0808X - Psychiatric/Mental Health Nurse Practitioner
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
333799214
Plan Year:
2024
Number Of Participants:
0
Plan Name:
401(K)
Sponsor's telephone number:
Plan Administrator / Signatory:
QIAN LIU(Plan administrator)
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