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NORTHWEST FUNCTIONAL NUTRITION, LLC

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Company Details

Legal Name: NORTHWEST FUNCTIONAL NUTRITION, LLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: November 26th 2018
Expiration date: 30 Nov 2025
UBI Number: 604 355 134
ZIP code: 98011
City: Bothell
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 19125 NORTH CREEK PKWY, SUITE 120, BOTHELL, WA, 98011-8000, UNITED STATES
Principal Office Mailing Address: Google Maps Logo PO BOX 821092, KENMORE, WA, 98028-0999, UNITED STATES

Contact Details

E-Mail: NWFNUTRITION@OUTLOOK.COM
Phone Number: +1 425-588-0480

Nature of Business

Other Services, NUTRITION COUNSELING

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Registered Agent Information

Name Role Address
ADAMS & CO, P.S., INC. Registered Agent 21907 64TH AVE W STE 320, MOUNTLAKE TER, WA, 98043-2299, UNITED STATES

Key Officers & Management

Name Role Address
NIKKI GEPNER Executor 19819 77TH AVE NE, KENMORE, WA, 98028-2122, UNITED STATES
NIKKI GEPNER Governing Person 19819 77TH AVE NE, KENMORE, WA, 98028-2122, UNITED STATES

National Provider Identifier

NPI Number:
1760022156
Certification Date:
2021-09-21

Authorized Person:

Name:
NIKKI GEPNER
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261Q00000X - Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
8334640125
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