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MODERN DERMATOLOGY, PLLC

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Company Details

Legal Name: MODERN DERMATOLOGY, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: January 7th 2015
Expiration date: 31 Jan 2026
UBI Number: 603 465 621
ZIP code: 98109
City: Seattle
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 1021 MERCER ST, SEATTLE, WA, 98109-4324, UNITED STATES
Supporting healthcare providers fighting with COVID-19: $110,802

Contact Details

E-Mail: ACCOUNTING@MDINSEATTLE.COM
Phone Number: +1 206-489-2530

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role
MODERN DERMATOLOGY, PLLC Registered Agent

Key Officers & Management

Name Role Address
JAMES COLLYER Governing Person 820 BLANCHARD ST UNIT 901, SEATTLE, WA, 98121-2650, UNITED STATES
HEATHER ASHBACH-ROGERS Governing Person 1024 E SHELBY ST, SEATTLE, WA, 98102-3821, UNITED STATES
HEATHER ROGERS EXECUTOR 1021 MERCER ST, SEATTLE, WA, 98109, UNITED STATES

National Provider Identifier

NPI Number:
1790178010
Certification Date:
2022-08-04
Link:
View on NPI website

Authorized Person:

Name:
DR. HEATHER D ROGERS
Role:
OWNER
Phone:
2064862982

Taxonomy:

Selected Taxonomy:
332900000X - Non-Pharmacy Dispensing Site
Is Primary:
No
Selected Taxonomy:
207N00000X - Dermatology Physician
Is Primary:
Yes

Contacts:

Phone:
+1 205-489-3206
Fax:
2069735380
Phone:
+1 206-486-2982

Form 5500 Series

Employer Identification Number (EIN):
472750505
Plan Year:
2023
Number Of Participants:
26
Plan Name:
401(K)
Sponsor's telephone number:
2064892530
File:
View File
Plan Year:
2023
Number Of Participants:
25
Plan Name:
CASH BALANCE
Sponsor's telephone number:
2064892530
File:
View File
Plan Year:
2022
Number Of Participants:
22
Plan Name:
CASH BALANCE
Sponsor's telephone number:
2064892530
File:
View File
Plan Year:
2022
Number Of Participants:
19
Plan Name:
401(K)
Sponsor's telephone number:
2064892530
File:
View File
Plan Year:
2021
Number Of Participants:
17
Plan Name:
CASH BALANCE
Sponsor's telephone number:
2064892530
File:
View File

Paycheck Protection Program

Jobs Reported:
16
Initial Approval Amount:
$356,319
Date Approved:
2020-04-27
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$356,319
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$360,753.19
Servicing Lender:
Commencement Bank
Use of Proceeds:
Payroll: $356,319

Trademarks

Serial Number:
88148376
Mark:
MD
Status:
Registered. The registration date is used to determine when post-regi...
Mark Type:
Service Mark
Application Filing Date:
2018-10-09
Mark Drawing Type:
3 - AN ILLUSTRATION DRAWING WHICH INCLUDES WORD(S)/ LETTER(S) /NUMBER(S)
Mark Literal Elements:
MD
USPTO Link:
View Trademark on United States Patent and Trademark Office Website

Goods And Services

For:
Medical services, namely, services in the field of dermatology; Medical dermatology assessment and treatment; Hygienic and beauty care for human beings; Providi...
First Use:
2015-05-20
International Classes:
044 - Primary Class
Class Status:
ACTIVE

Related by address

1021 MERCER ST, SEATTLE, WA, 98109-4324, UNITED STATES

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