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KITSAP COLORECTAL SURGERY, INC., P.S.

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Company Details

Legal Name: KITSAP COLORECTAL SURGERY, INC., P.S.
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL SERVICE CORPORATION
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: February 11th 1999
Date of Dissolution: June 1st 2012
Expiration date: 28 Feb 2012
UBI Number: 601 931 930

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Registered Agent Information

Name Role Address
TODD A BUSKIRK Registered Agent 3256 CHICO WAY NW, BREMERTON, WA, 98312, UNITED STATES

Key Officers & Management

Name Role
JOHNNY GREEN Governing Person

National Provider Identifier

NPI Number:
1245566348

Authorized Person:

Name:
DR. JOHNNY B GREEN
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
208C00000X - Colon & Rectal Surgery Physician
Is Primary:
No
Selected Taxonomy:
208600000X - Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
3603774134
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