LYNNE P. CLARK MD PS

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Company Details

Legal Name:	LYNNE P. CLARK MD PS
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL SERVICE CORPORATION
Category:	DOMESTIC ENTITY
Status:	Administratively Dissolved
Formation/ Registration Date:	April 25th 2000
Date of Dissolution:	August 3rd 2015
Expiration date:	30 Apr 2015
UBI Number:	602 031 972

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Registered Agent Information

Name	Role	Address
JAMES M NARDI	Registered Agent	1724 S MOUNTAIN VIEW AVE, TACOMA, WA, 98465, UNITED STATES

Key Officers & Management

Name	Role	Address
LYNNE CLARK	Governing Person	1724 S MOUNTAIN VIEW AVE, TACOMA, WA, 98465, UNITED STATES
JAMES NARDI	Governing Person	1724 S MOUNTAIN VIEW AVE, TACOMA, WA, 98465, UNITED STATES

National Provider Identifier

NPI Number:

1548384811

Link:

View on NPI website

Authorized Person:

Name:

DR. LYNNE PATRICIA CLARK

Role:

PRESIDENT

Phone:

2537528882

Taxonomy:

Selected Taxonomy:

208600000X - Surgery Physician

Is Primary:

Yes

Contacts:

Phone:

+1 253-752-8882

Fax:

2537528907

Form 5500 Series

Employer Identification Number (EIN):

912033647

Plan Year:

2013

Number Of Participants:

4

Plan Name:

401(K)

Sponsor's telephone number:

2533778806

File:

Plan Administrator / Signatory:

JAMES NARDI(Plan administrator)

Plan Year:

2012

Number Of Participants:

6

Plan Name:

401(K)

Sponsor's telephone number:

2533778806

File:

Plan Administrator / Signatory:

JAMES M NARDI(Plan administrator)

Plan Year:

2011

Number Of Participants:

6

Plan Name:

401(K)

Sponsor's telephone number:

2537528882

File:

Plan Administrator / Signatory:

JAMES M NARDI(Plan administrator)

Plan Year:

2010

Number Of Participants:

5

Plan Name:

401(K)

Sponsor's telephone number:

2537528882

Plan Administrator / Signatory:

JAMES M NARDI(Employer/plan sponsor)

Plan Year:

2010

Number Of Participants:

5

Plan Name:

401(K)

Sponsor's telephone number:

2537528882

File:

Plan Administrator / Signatory:

JAMES NARDI(Plan administrator)

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