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MICGRA PSYCH L.L.C.

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Company Details

Legal Name: MICGRA PSYCH L.L.C.
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: April 2nd 2021
Expiration date: 30 Apr 2026
UBI Number: 604 740 104
ZIP code: 98188
City: Seattle
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 555 ANDOVER PARK W # 200, TUKWILA, WA, 98188-3379, UNITED STATES

Contact Details

E-Mail: AMANDA@MICGRAPSYCH.COM
Phone Number: +1 206-905-3600

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
MICGRA PSYCH LLC Registered Agent 555 ANDOVER PARK W STE 200, TUKWILA, WA, 98188-3379, UNITED STATES

Key Officers & Management

Name Role Address
AMANDA BUTLER Executor 301 W I PKWY, UNIT C, DALLAS, GA, 30132-5066, UNITED STATES
AMANDA BUTLER Governing Person 555 ANDOVER PARK W STE 200, SUITE 200, TUKWILA, WA, 98188-3379, UNITED STATES

National Provider Identifier

NPI Number:
1366255432
Certification Date:
2025-01-30

Authorized Person:

Name:
ODETTE AMANDA E BUTLER
Role:
PSYCHIATRIC NURSE PRACTITIONER
Phone:

Taxonomy:

Selected Taxonomy:
363LP0808X - Psychiatric/Mental Health Nurse Practitioner
Is Primary:
Yes

Contacts:

Fax:
2064854710
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