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NORTHWEST BEHAVIORAL MEDICINE, PLLC

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Company Details

Legal Name: NORTHWEST BEHAVIORAL MEDICINE, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: December 4th 2003
Date of Dissolution: May 3rd 2019
Expiration date: 31 Dec 2018
UBI Number: 602 346 550

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Registered Agent Information

Name Role Address
MICHAEL BERNSTEIN Registered Agent 3400 MAIN ST, VANCOUVER, WA, 98668-0000, UNITED STATES

Key Officers & Management

Name Role
MICHAEL BERNSTEIN Governing Person

National Provider Identifier

NPI Number:
1851358253

Authorized Person:

Name:
MR. CHRISTOPHER PHILLIPS
Role:
BILLING MANAGER
Phone:

Taxonomy:

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

Contacts:

Fax:
5032839527
Fax:
3606965032
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