KITSAP GENERAL SURGERY, PLLC

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Company Details

Legal Name:	KITSAP GENERAL SURGERY, PLLC
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Active
Formation/ Registration Date:	June 2nd 2006
Expiration date:	30 Jun 2026
UBI Number:	602 620 352
ZIP code:	98383
City:	Silverdale
County:	KITSAP
Home State:	WASHINGTON
Principal Office Street Address:	9927 MICKELBERRY RD NW STE 121, SILVERDALE, WA, 98383-7861, UNITED STATES
Supporting healthcare providers fighting with COVID-19:	$174,285

Contact Details

E-Mail:	BEVERLYMILLARDBOOKKEEPING@GMAIL.COM
Phone Number:	+1 360-613-1335

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name	Role	Address
THOMAS WIXTED	Registered Agent	9927 MICKELBERRY RD NW STE 121, SILVERDALE, WA, 98383-7861, UNITED STATES

Key Officers & Management

Name	Role	Address
KRISTAN GUENTERBERG	Governing Person	9927 MICKELBERRY RD NW STE 121, SILVERDALE, WA, 98383, UNITED STATES
THOMAS WIXTED	Governing Person	9927 MICKELBERRY RD NW STE 121, SILVERDALE, WA, 98383, UNITED STATES

National Provider Identifier

NPI Number:

1912010984

Link:

View on NPI website

Authorized Person:

Name:

TY CHUN

Role:

PHYSICIANPARTNER

Phone:

3606131335

Taxonomy:

Selected Taxonomy:

208600000X - Surgery Physician

Is Primary:

Yes

Contacts:

Phone:

+1 360-613-1335

Fax:

3606131329

Form 5500 Series

Employer Identification Number (EIN):

205273976

Plan Year:

2024

Number Of Participants:

9

Plan Name:

401(K)

Sponsor's telephone number:

3606131335

File:

Plan Administrator / Signatory:

ANGELA SIEGRIST(Plan administrator)

Plan Year:

2023

Number Of Participants:

10

Plan Name:

401(K)

Sponsor's telephone number:

3606131335

File:

Plan Administrator / Signatory:

ANGELA SIEGRIST(Plan administrator)

Plan Year:

2022

Number Of Participants:

12

Plan Name:

401(K)

Sponsor's telephone number:

3606131335

File:

Plan Administrator / Signatory:

ANGELA SIEGRIST(Plan administrator)

Plan Year:

2021

Number Of Participants:

11

Plan Name:

401(K)

Sponsor's telephone number:

3606131335

File:

Plan Administrator / Signatory:

ANGELA SIEGRIST(Plan administrator)

Plan Year:

2020

Number Of Participants:

10

Plan Name:

401(K)

Sponsor's telephone number:

3606131335

File:

Plan Administrator / Signatory:

WENDIE POND(Plan administrator)

Paycheck Protection Program

Jobs Reported:

6

Initial Approval Amount:

$128,487

Date Approved:

2020-05-01

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$128,487

Race:

White

Ethnicity:

Not Hispanic or Latino

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$129,768.3

Servicing Lender:

U.S. Bank, National Association

Use of Proceeds:

Payroll: $128,487

Related by address

9927 MICKELBERRY RD NW STE 121, SILVERDALE, WA, 98383-7861, UNITED STATES

KITSAP GENERAL SURGERY PROPERTY LLC

OLYMPIC PLASTIC SURGERY CENTER LLC

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