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MARYALICE HARDISON TELEMEDICINE, PLLC

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Company Details

Legal Name: MARYALICE HARDISON TELEMEDICINE, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: July 28th 2022
Expiration date: 31 Jul 2026
UBI Number: 604 951 221
ZIP code: 98902
City: Yakima
County: YAKIMA
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 707 S 17TH AVE, YAKIMA, WA, 98902-4203, UNITED STATES

Contact Details

E-Mail: MARYALICEFNP@GMAIL.COM
Phone Number: +1 561-543-7064

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
MARYALICE HARDISON Registered Agent 707 S 17TH AVE, YAKIMA, WA, 98902-4203, UNITED STATES

Key Officers & Management

Name Role Address
MARYALICE HARDISON Executor 707 S 17TH AVE, YAKIMA, WA, 98902-4203, UNITED STATES
MARYALICE HARDISON Governing Person 707 S 17TH AVE, YAKIMA, WA, 98902-4203, UNITED STATES

National Provider Identifier

NPI Number:
1073240636
Certification Date:
2022-08-03

Authorized Person:

Name:
MS. MARYALICE HARDISON
Role:
FOUNDER
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

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