LACAMAS MEDICAL GROUP, P.C.

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Company Details

Legal Name:	LACAMAS MEDICAL GROUP, P.C.
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL SERVICE CORPORATION
Category:	DOMESTIC ENTITY
Status:	Administratively Dissolved
Formation/ Registration Date:	May 8th 2003
Date of Dissolution:	October 3rd 2021
Expiration date:	31 May 2021
UBI Number:	602 284 049
ZIP code:	98607
City:	Camas
County:	CLARK
Home State:	WASHINGTON
Principal Office Street Address:	3240 NE 3RD AVE, CAMAS, WA, 98607-2408, UNITED STATES
Supporting healthcare providers fighting with COVID-19:	$52,396

Contact Details

E-Mail:	SJONASON@LACAMASMEDICALGROUP.COM
Phone Number:	+1 360-838-2440

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name	Role	Address
SCOTT JONASON	Registered Agent	3240 NE 3RD AVE, CAMAS, WA, 98607-2408, UNITED STATES

Key Officers & Management

Name	Role	Address
SCOTT JONASON	Governing Person	3240 NE 3RD AVE, CAMAS, WA, 98607, UNITED STATES
REBECCA JONASON	Governing Person	3240 NE 3RD AVE, CAMAS, WA, 98607, UNITED STATES

National Provider Identifier

NPI Number:

1649280462

Link:

View on NPI website

Authorized Person:

Name:

SCOTT JONASON

Role:

PRESIDENT

Phone:

3608382440

Taxonomy:

Selected Taxonomy:

363A00000X - Physician Assistant

Is Primary:

Yes

Contacts:

Phone:

+1 360-838-2440

Fax:

3608382450

Form 5500 Series

Employer Identification Number (EIN):

050559955

Plan Year:

2020

Number Of Participants:

34

Plan Name:

401(K)

Sponsor's telephone number:

3608382440

File:

Plan Administrator / Signatory:

SCOTT JONASON(Plan administrator)

Plan Year:

2019

Number Of Participants:

33

Plan Name:

401(K)

Sponsor's telephone number:

3608382440

File:

Plan Administrator / Signatory:

SCOTT JONASON(Plan administrator)

Plan Year:

2018

Number Of Participants:

32

Plan Name:

401(K)

Sponsor's telephone number:

3608382440

File:

Plan Administrator / Signatory:

SCOTT JONASON(Plan administrator)

Plan Year:

2017

Number Of Participants:

39

Plan Name:

401(K)

Sponsor's telephone number:

3608382440

File:

Plan Administrator / Signatory:

SCOTT JONASON(Plan administrator)

Plan Year:

2016

Number Of Participants:

29

Plan Name:

401(K)

Sponsor's telephone number:

3608382440

File:

Plan Administrator / Signatory:

SCOTT JONASON(Plan administrator)

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