LAKE WASHINGTON PRIVATE MEDICINE, INC.

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Company Details

Legal Name:	LAKE WASHINGTON PRIVATE MEDICINE, INC.
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFIT CORPORATION
Category:	DOMESTIC ENTITY
Status:	Active
Formation/ Registration Date:	April 21st 2003
Expiration date:	30 Apr 2026
UBI Number:	602 289 671
ZIP code:	98036
City:	Lynnwood
County:	SNOHOMISH
Home State:	WASHINGTON
Principal Office Street Address:	1327 215TH PL SW, LYNNWOOD, WA, 98036-8681, UNITED STATES
Supporting healthcare providers fighting with COVID-19:	$17,936

Contact Details

E-Mail:	ERICASHIRAZI@GMAIL.COM
Phone Number:	+1 206-422-7537

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name	Role	Address
DAVID NAIBERT	Registered Agent	12515 NE 116TH ST, APT B23, KIRKLAND, WA, 98034-8448, UNITED STATES

Key Officers & Management

Name	Role
VICTORIA POSTOLIT	Governing Person
DAVID NAIBERT	Governing Person

National Provider Identifier

NPI Number:

1427109271

Certification Date:

2024-01-01

Link:

View on NPI website

Authorized Person:

Name:

DR. DAVID KEITH NAIBERT

Role:

OWNER

Phone:

4256788534

Taxonomy:

Selected Taxonomy:

208VP0000X - Pain Medicine Physician

Is Primary:

Yes

Contacts:

Phone:

+1 425-678-8534

Fax:

4256788564

Form 5500 Series

Employer Identification Number (EIN):

320071647

Plan Year:

2024

Number Of Participants:

3

Plan Name:

401(K)

Sponsor's telephone number:

4256788534

File:

Plan Administrator / Signatory:

QIAN LIU(Plan administrator)

Plan Year:

2020

Number Of Participants:

4

Plan Name:

401(K)

Sponsor's telephone number:

2062005867

File:

Plan Administrator / Signatory:

DAVID NAIBERT(Plan administrator)

Plan Year:

2020

Number Of Participants:

1

Plan Name:

CASH BALANCE

Sponsor's telephone number:

2062005867

File:

Plan Administrator / Signatory:

DAVID NAIBERT(Plan administrator)

Plan Year:

2020

Number Of Participants:

4

Plan Name:

CASH BALANCE

Sponsor's telephone number:

2062005867

File:

Plan Administrator / Signatory:

DAVID NAIBERT(Plan administrator)

Plan Year:

2019

Number Of Participants:

4

Plan Name:

401(K)

Sponsor's telephone number:

2062005867

File:

Plan Administrator / Signatory:

DAVID NAIBERT(Plan administrator)

Paycheck Protection Program

Jobs Reported:

3

Initial Approval Amount:

$63,927

Date Approved:

2020-04-28

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$16,032

Race:

White

Ethnicity:

Unknown/NotStated

Gender:

Male Owned

Veteran:

Veteran

Forgiveness Amount:

$16,126.87

Servicing Lender:

Heritage Bank

Use of Proceeds:

Payroll: $16,032

Related by address

1327 215TH PL SW, LYNNWOOD, WA, 98036-8681, UNITED STATES

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