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MARY K. SIMONSON, M.D. P.L.L.C.

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Company Details

Legal Name: MARY K. SIMONSON, M.D. P.L.L.C.
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: February 25th 2020
Expiration date: 28 Feb 2026
UBI Number: 604 586 428
ZIP code: 98402
City: Tacoma
County: PIERCE
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 4041 RUSTON WAY STE 202, TACOMA, WA, 98402-5300, UNITED STATES

Contact Details

E-Mail: MARYSIMONSON73@GMAIL.COM
Phone Number: +1 253-759-0288

Nature of Business

Health Care, Social Assistance & Service Organization, PSYCHIATRY

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Registered Agent Information

Name Role Address
MARY K. SIMONSON, M.D. Registered Agent 4041 RUSTON WAY STE 202, TACOMA, WA, 98402-5300, UNITED STATES

Key Officers & Management

Name Role Address
MARY SIMONSON Executor 4041 RUSTON WAY STE 202, TACOMA, WA, 98402-5300, UNITED STATES
MARY SIMONSON Governing Person 4041 RUSTON WAY STE 202, TACOMA, WA, 98402-5300, UNITED STATES

National Provider Identifier

NPI Number:
1295334555
Certification Date:
2020-10-19

Authorized Person:

Name:
MARY K SIMONSON
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QM2500X - Medical Specialty Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2537613288
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