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NEUROSMART, PLLC

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Company Details

Legal Name: NEUROSMART, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: August 5th 2024
Expiration date: 31 Aug 2025
UBI Number: 605 588 072
ZIP code: 98057
City: Renton
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 321 BURNETT AVE S FL 2, RENTON, WA, 98057-2558, UNITED STATES

Contact Details

E-Mail: INFO@PRISMAWELLNESS.COM
Phone Number: +1 206-785-1015

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
DANIELA BORQUEZ Registered Agent 321 BURNETT AVE S FL 2, RENTON, WA, 98057-2558, UNITED STATES

Key Officers & Management

Name Role Address
SCOTT WIENER Executor 1205 N 10TH PL APT 2125, RENTON, WA, 98057-5492, UNITED STATES
EMMA NAUMAN Executor 1811 4TH AVE W, SEATTLE, WA, 98119-3020, UNITED STATES
KORY SIMONSEN Executor 10904 167TH AVE NE, REDMOND, WA, 98052-2752, UNITED STATES
SCOTT WIENER Governing Person 305 111TH AVE NE, STE B, BELLEVUE, WA, 98004-8361, UNITED STATES

National Provider Identifier

NPI Number:
1568292266
Certification Date:
2024-08-06

Authorized Person:

Name:
DR. SCOTT WIENER
Role:
CHIEF MEDICAL OFFICER
Phone:

Taxonomy:

Selected Taxonomy:
2084P0800X - Psychiatry Physician
Is Primary:
Yes

Contacts:

Fax:
2067851023
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