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MICHAEL S. EICKERMAN, MD. PS

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Company Details

Legal Name: MICHAEL S. EICKERMAN, MD. PS
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL SERVICE CORPORATION
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: October 20th 2005
Date of Dissolution: February 1st 2016
Expiration date: 31 Oct 2015
UBI Number: 602 549 940
ZIP code: 98272
City: Monroe
County: SNOHOMISH
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 14841 179TH AVE SE # 140, MONROE, WA, 98272, UNITED STATES

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Registered Agent Information

Name Role Address
MICHAEL S EICKERMAN MD Registered Agent 14841 179TH AVE SE STE 140, MONROE, WA, 98272, UNITED STATES

Key Officers & Management

Name Role Address
MICHAEL EICKERMAN Governing Person 14841 179TH AVE SE STE 140, MONROE, WA, 98272, UNITED STATES

National Provider Identifier

NPI Number:
1548368798

Authorized Person:

Name:
DR. MICHAEL S. EICKERMAN
Role:
GENERAL SURGEON
Phone:

Taxonomy:

Selected Taxonomy:
208600000X - Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
3608053456
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