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KITSAP SPINE & WELLNESS, PLLC

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Company Details

Legal Name: KITSAP SPINE & WELLNESS, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: November 7th 2019
Expiration date: 30 Nov 2025
UBI Number: 604 531 518
ZIP code: 98383
City: Silverdale
County: KITSAP
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 3888 NW RANDALL WAY, SUITE 202, SILVERDALE, WA, 98383-7847, UNITED STATES

Contact Details

E-Mail: JONEE@JDTAXANDACCOUNTING.COM
Phone Number: +1 360-698-4411

Nature of Business

Any Lawful Purpose

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Registered Agent Information

Name Role Address
JONEE DUBOS Registered Agent 3331 KITSAP WAY, BREMERTON, WA, 98312-2670, UNITED STATES

Key Officers & Management

Name Role Address
MARK GOODMAN Governing Person -
DR. MARK T. GOODMAN, DC EXECUTOR 10513 SILVERDALE WAY NW STE 103, SILVERDALE, WA, 98383-9499, UNITED STATES

National Provider Identifier

NPI Number:
1649817354
Certification Date:
2021-04-30

Authorized Person:

Name:
DR. MARK THOMAS GOODMAN
Role:
OWNER/PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
111N00000X - Chiropractor
Is Primary:
Yes

Contacts:

Fax:
3603771903
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