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NORTH STAR CLINIC LLC

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Company Details

Legal Name: NORTH STAR CLINIC LLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: September 23rd 2019
Expiration date: 30 Sep 2025
UBI Number: 604 517 744
ZIP code: 98368
City: Port Townsend
County: JEFFERSON
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 2120 LAWRENCE ST, PORT TOWNSEND, WA, 98368-7925, UNITED STATES

Contact Details

E-Mail: ADMIN@NORTHSTAR-CLINIC.COM
Phone Number: +1 360-344-8146

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
JAMES BLAIR III Registered Agent 2120 LAWRENCE ST, PORT TOWNSEND, WA, 98368-7925, UNITED STATES

Key Officers & Management

Name Role Address
JAMES BLAIR III Executor 1136 WATER ST, SUITE 111, PORT TOWNSEND, WA, 98368-6728, UNITED STATES
AMY PETERSON Executor 1136 WATER ST, SUITE 111, PORT TOWNSEND, WA, 98368-6728, UNITED STATES
JAMES BLAIR Governing Person -
AMY PETERSON Governing Person -

National Provider Identifier

NPI Number:
1740823566
Certification Date:
2022-11-21

Authorized Person:

Name:
MR. JAMES CLAYTON BLAIR III
Role:
MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
3603448411

History

Type Old value New value Date of change
Name change NORTH STAR CLINIC, LLC NORTH STAR CLINIC LLC 2020-01-08
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