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KETAMINE WELLNESS CENTERS WASHINGTON, LLC

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Company Details

Legal Name: KETAMINE WELLNESS CENTERS WASHINGTON, LLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: June 1st 2018
Date of Dissolution: November 3rd 2023
Expiration date: 30 Jun 2023
UBI Number: 604 291 798
ZIP code: 98003
City: Federal Way
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 34709 9TH AVE. S STE 200, FEDERAL WAY, WA, 98003-8722, UNITED STATES
Principal Office Mailing Address: Google Maps Logo 113 W HOOVER AVE, SUITE 101, MESA, AZ, 85210, UNITED STATES

Contact Details

E-Mail: JULIE@KETAMINEWELLNESSCENTERS.COM
Phone Number: +1 480-788-8539

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
KEVIN NICHOLSON Registered Agent 34709 9TH AVE S STE 200, FEDERAL WAY, WA, 98003-8722, UNITED STATES

Key Officers & Management

Name Role Address
JULIE NICHOLSON Governing Person -
JULIE NICHOLSON EXECUTOR 2152 S VINEYARD STE 131, MESA, AZ, 85210-6882, UNITED STATES

National Provider Identifier

NPI Number:
1457918831
Certification Date:
2020-12-21
Link:
View on NPI website

Authorized Person:

Name:
ANITA D JERGER
Role:
EXECUTIVE ASSISTANT
Phone:
8555389355

Taxonomy:

Selected Taxonomy:
163W00000X - Registered Nurse
Is Primary:
No
Selected Taxonomy:
208VP0000X - Pain Medicine Physician
Is Primary:
No
Selected Taxonomy:
207L00000X - Anesthesiology Physician
Is Primary:
Yes

Contacts:

Phone:
+1 855-538-9355
Fax:
8445389355

Paycheck Protection Program

Jobs Reported:
18
Initial Approval Amount:
$45,322
Date Approved:
2021-03-17
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$45,322
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$45,545.51
Servicing Lender:
Zions Bank, A Division of
Use of Proceeds:
Payroll: $45,322
Jobs Reported:
16
Initial Approval Amount:
$43,200
Date Approved:
2020-05-13
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$43,200
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$43,636.73
Servicing Lender:
Zions Bank, A Division of
Use of Proceeds:
Payroll: $43,200
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