L. KEITH HANSON, PLLC

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Company Details

Legal Name:	L. KEITH HANSON, PLLC
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Administratively Dissolved
Formation/ Registration Date:	January 17th 2003
Date of Dissolution:	May 1st 2015
Expiration date:	31 Jan 2015
UBI Number:	602 264 318

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Registered Agent Information

Name	Role	Address
L KEITH HANSON	Registered Agent	520 W INDIAN AVE, BREWSTER, WA, 98812, UNITED STATES

Key Officers & Management

Name	Role	Address
L HANSON	Governing Person	P O BOX 337, BREWSTER, WA, 98812, UNITED STATES

National Provider Identifier

NPI Number:

1316138720

Link:

View on NPI website

Authorized Person:

Name:

MELODIE WHITE

Role:

ADMINISTRATOR

Phone:

5096892525

Taxonomy:

Selected Taxonomy:

261QR1300X - Rural Health Clinic/Center

Is Primary:

Yes

Contacts:

Phone:

+1 509-689-2525

Fax:

5096893247

Form 5500 Series

Employer Identification Number (EIN):

743076074

Plan Year:

2012

Number Of Participants:

21

Sponsor's telephone number:

5096892525

File:

Plan Administrator / Signatory:

L. KEITH HANSON MD(Plan administrator)

Plan Year:

2011

Number Of Participants:

20

Sponsor's telephone number:

5096892525

File:

Plan Administrator / Signatory:

L. KEITH HANSON MD(Plan administrator)

Plan Year:

2010

Number Of Participants:

21

Sponsor's telephone number:

5096892525

File:

Plan Administrator / Signatory:

L. KEITH HANSON MD(Plan administrator)

Plan Year:

2009

Number Of Participants:

16

Sponsor's telephone number:

5096892525

File:

Plan Administrator / Signatory:

L. KEITH HANSON MD(Plan administrator)

Plan Year:

2009

Number Of Participants:

16

Sponsor's telephone number:

5096892525

Plan Administrator / Signatory:

L. KEITH HANSON, MD(Plan administrator)

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