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LOWER COLUMBIA AMBULATORY SURGERY CENTER, PLLC
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Company Details
Legal Name:
LOWER COLUMBIA AMBULATORY SURGERY CENTER, PLLC
Jurisdiction:
WASHINGTON
Entity Type:
WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category:
DOMESTIC ENTITY
Status:
Inactive
Formation/ Registration Date:
September 28th 2000
Date of Dissolution:
January 3rd 2011
Expiration date:
30 Sep 2010
UBI Number:
602 068 997
ZIP code:
98632
City:
Longview
County:
COWLITZ
Home State:
WASHINGTON
Principal Office Street Address:
820 11TH AVE, LONGVIEW, WA, 98632, UNITED STATES
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Registered Agent Information
Name
Role
Address
DONALD W FREY
Registered Agent
600 ROYAL STREET W # B, KELSO, WA, 98626, UNITED STATES
Key Officers & Management
Name
Role
ALEXANDER IEROKOMOS
Governing Person
National Provider Identifier
NPI Number:
1710927553
Link:
View on NPI website
Authorized Person:
Name:
ALEXANDER IEROKOMOS
Role:
OWNER
Phone:
3604230960
Taxonomy:
Selected Taxonomy:
261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary:
Yes
Contacts:
Phone:
+1 360-423-0960
Fax:
3604238778
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