MORGAN L. ANDERSEN, DDS, P.S.

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Company Details

Legal Name:	MORGAN L. ANDERSEN, DDS, P.S.
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL SERVICE CORPORATION
Category:	DOMESTIC ENTITY
Status:	Voluntarily Dissolved
Formation/ Registration Date:	January 3rd 2011
Date of Dissolution:	December 4th 2019
Expiration date:	31 Jan 2020
UBI Number:	603 074 715
ZIP code:	98684
City:	Vancouver
County:	CLARK
Home State:	WASHINGTON
Principal Office Street Address:	12116 SE MILL PLAIN BLVD, VANCOUVER, WA, 98684, UNITED STATES
Principal Office Mailing Address:	1610 C ST STE 207, VANCOUVER, WA, 98663-3400, UNITED STATES

Contact Details

E-Mail:

JPOLIKARPOV@DUFFYKEKEL.COM

Nature of Business

DENTAL PRACTICE

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Registered Agent Information

Name	Role	Address
DK WASHINGTON, INC.	Registered Agent	1610 C ST STE 207, VANCOUVER, WA, 98663-3400, UNITED STATES

Key Officers & Management

Name	Role
MORGAN ANDERSEN	Governing Person
JULIE ANDERSEN	Governing Person

National Provider Identifier

NPI Number:

1134265655

Link:

View on NPI website

Authorized Person:

Name:

MS. KENDRA SHANK

Role:

PATIENT SPECIALIST

Phone:

3602568200

Taxonomy:

Selected Taxonomy:

122300000X - Dentist

Is Primary:

Yes

Contacts:

Phone:

+1 360-256-8200

Fax:

3602569356

Form 5500 Series

Employer Identification Number (EIN):

274439544

Plan Year:

2018

Number Of Participants:

5

Sponsor's telephone number:

3602568200

File:

Plan Administrator / Signatory:

MORGAN L. ANDERSEN(Plan administrator)

Plan Year:

2017

Number Of Participants:

5

Sponsor's telephone number:

3602568200

File:

Plan Administrator / Signatory:

MORGAN L. ANDERSEN(Plan administrator)

Plan Year:

2016

Number Of Participants:

5

Sponsor's telephone number:

3602568200

File:

Plan Administrator / Signatory:

MORGAN L. ANDERSEN(Plan administrator)

Plan Year:

2015

Number Of Participants:

6

Sponsor's telephone number:

3602568200

Plan Administrator / Signatory:

MORGAN L. ANDERSEN(Plan administrator)

Plan Year:

2014

Number Of Participants:

6

Sponsor's telephone number:

3602568200

File:

Plan Administrator / Signatory:

MORGAN L. ANDERSEN(Plan administrator)

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