LAKE WASHINGTON VASCULAR, PLLC

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Company Details

Legal Name:	LAKE WASHINGTON VASCULAR, PLLC
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Active
Formation/ Registration Date:	October 5th 2000
Expiration date:	31 Oct 2025
UBI Number:	602 070 340
ZIP code:	98004
City:	Bellevue
County:	KING
Home State:	WASHINGTON
Principal Office Street Address:	1135 116TH AVE NE #305, BELLEVUE, WA, 98004, UNITED STATES
Supporting healthcare providers fighting with COVID-19:	$104,566

Contact Details

E-Mail:	BUSINESS2@LKWV.COM
Phone Number:	+1 425-453-1772

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name	Role	Address
MANAGING MEMBER	Registered Agent	1135 116TH AVE NE STE 305, BELLEVUE, WA, 98004-4623, UNITED STATES

Key Officers & Management

Name	Role
KATHLEEN GIBSON	Governing Person
RENEE MINJAREZ	Governing Person
BRIAN FERRIS	Governing Person

National Provider Identifier

NPI Number:

1942292875

Link:

View on NPI website

Authorized Person:

Name:

DANIEL PEPPER

Role:

MANAGING PARTNER, PLLC

Phone:

4254531772

Taxonomy:

Selected Taxonomy:

2086S0129X - Vascular Surgery Physician

Is Primary:

Yes

Contacts:

Phone:

+1 425-453-1772

Fax:

4254530603

Form 5500 Series

Employer Identification Number (EIN):

912079942

Plan Year:

2023

Number Of Participants:

52

Plan Name:

401(K)

Sponsor's telephone number:

4254531772

File:

Plan Administrator / Signatory:

KATHLEEN GIBSON, MD(Plan administrator)

Plan Year:

2022

Number Of Participants:

54

Plan Name:

401(K)

Sponsor's telephone number:

4254531772

File:

Plan Administrator / Signatory:

BRIAN FERRIS MD(Plan administrator)

Plan Year:

2021

Number Of Participants:

54

Plan Name:

401(K)

Sponsor's telephone number:

4254531772

File:

Plan Administrator / Signatory:

BRIAN FERRIS, MD(Plan administrator)

Plan Year:

2020

Number Of Participants:

55

Plan Name:

401(K)

Sponsor's telephone number:

4254531772

File:

Plan Administrator / Signatory:

BRIAN FERRIS, MD(Plan administrator)

Plan Year:

2019

Number Of Participants:

53

Plan Name:

401(K)

Sponsor's telephone number:

4254531772

File:

Plan Administrator / Signatory:

BRIAN FERRIS, MD(Plan administrator)

Paycheck Protection Program

Jobs Reported:

37

Initial Approval Amount:

$561,520

Date Approved:

2020-04-07

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$561,520

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$565,658.33

Servicing Lender:

Heritage Bank

Use of Proceeds:

Payroll: $561,520

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