MILL CREEK FAMILY PRACTICE, P.L.L.C.

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Company Details

Legal Name:	MILL CREEK FAMILY PRACTICE, P.L.L.C.
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Administratively Dissolved
Formation/ Registration Date:	March 1st 2005
Date of Dissolution:	August 3rd 2024
Expiration date:	31 Mar 2024
UBI Number:	602 478 366
ZIP code:	98012
City:	Bothell
County:	SNOHOMISH
Home State:	WASHINGTON
Principal Office Street Address:	1025 153RD STREET SE STE 200, MILL CREEK, WA, 98012, UNITED STATES
Supporting healthcare providers fighting with COVID-19:	$359,035

Contact Details

E-Mail:	MALVAREZ@MILLCREEKFAMILYPRACTICE.ORG
Phone Number:	+1 425-338-4044

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name	Role	Address
H&F SERVICES, INC.	Registered Agent	1 N TACOMA AVE STE 300, TACOMA, WA, 98403-3131, UNITED STATES

Key Officers & Management

Name	Role	Address
STEPHEN STUKOVSKY	Governing Person	-
WILLIAM BACON	Governing Person	-
MATTHEW PRICE	Governing Person	-
RANDALL GOULD	EXECUTOR	1025 153RD ST SE SUITE 200, MILL CREEK, WA, 98012, UNITED STATES

National Provider Identifier

NPI Number:

1598806770

Link:

View on NPI website

Authorized Person:

Name:

DR. MARK T ANDERSON

Role:

PHYSICIAN

Phone:

4253384000

Taxonomy:

Selected Taxonomy:

207Q00000X - Family Medicine Physician

Is Primary:

Yes

Contacts:

Phone:

+1 425-338-4000

Fax:

4257456158

Form 5500 Series

Employer Identification Number (EIN):

202439394

Plan Year:

2023

Number Of Participants:

34

Plan Name:

401(K)

Sponsor's telephone number:

4253384000

File:

Plan Year:

2023

Number Of Participants:

1

Plan Name:

401(K)

Sponsor's telephone number:

4253384044

File:

Plan Year:

2023

Number Of Participants:

1

Plan Name:

401(K)

Sponsor's telephone number:

4253384044

Plan Year:

2022

Number Of Participants:

35

Plan Name:

401(K)

Sponsor's telephone number:

4253384000

File:

Plan Year:

2021

Number Of Participants:

37

Plan Name:

401(K)

Sponsor's telephone number:

4253384000

File:

Paycheck Protection Program

Jobs Reported:

31

Initial Approval Amount:

$429,350

Date Approved:

2020-04-14

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$429,350

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$432,255.46

Servicing Lender:

KeyBank National Association

Use of Proceeds:

Payroll: $429,350

Jobs Reported:

29

Initial Approval Amount:

$424,737

Date Approved:

2021-01-23

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$424,737

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$427,646.16

Servicing Lender:

KeyBank National Association

Use of Proceeds:

Payroll: $424,733
Utilities: $1

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