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NORTHSIDE INTERNAL MEDICINE ASSOCIATES, P.S.

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Company Details

Legal Name: NORTHSIDE INTERNAL MEDICINE ASSOCIATES, P.S.
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL SERVICE CORPORATION
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: March 15th 1984
Date of Dissolution: July 1st 2015
Expiration date: 31 Mar 2015
UBI Number: 600 520 851

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Registered Agent Information

Name Role Address
TIMOTHY J GARDNER Registered Agent 6120 N MAYFAIR ST, SPOKANE, WA, 99208, UNITED STATES

Key Officers & Management

Name Role
MARY BADGER Governing Person
KEN CETHCART Governing Person
TIMOTHY GARDNER Governing Person

National Provider Identifier

NPI Number:
1114966769

Authorized Person:

Name:
TIMOTHY J GARDNER
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207RE0101X - Endocrinology, Diabetes & Metabolism Physician
Is Primary:
No
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
5094894572

Form 5500 Series

Employer Identification Number (EIN):
911240863
Plan Year:
2010
Number Of Participants:
11
Plan Name:
RETIREMENT PLAN
Sponsor's telephone number:
Plan Administrator / Signatory:
H. KENNEDY CATHCART MD(Plan administrator)
Plan Year:
2009
Number Of Participants:
39
Plan Name:
RETIREMENT PLAN
Sponsor's telephone number:
Plan Administrator / Signatory:
H. KENNEDY CATHCART MD(Plan administrator)
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