NORTHWEST PSYCHIATRY, INC., P.S.

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Company Details

Legal Name:

Jurisdiction:

WASHINGTON

Entity Type:

WA PROFESSIONAL SERVICE CORPORATION

Category:

DOMESTIC ENTITY

Status:

Administratively Dissolved

Formation/ Registration Date:

February 27th 2014

Date of Dissolution:

July 3rd 2017

Expiration date:

28 Feb 2017

UBI Number:

603 380 476

Registered Agent Information

Name	Role	Address
NORM SHORT	Registered Agent	1155 BETHEL AVE, PORT ORCHARD, WA, 98366-0000, UNITED STATES

Name

Role

Address

NORM SHORT

Registered Agent

1155 BETHEL AVE, PORT ORCHARD, WA, 98366-0000, UNITED STATES

Key Officers & Management

Name	Role	Address
JANET VONDRAN	Governing Person	2528 WHEATON WAY STE #204, BREMERTON, WA, 98310, UNITED STATES
MIKE JACKSON	Governing Person	2528 WHEATON WAY STE #204, BREMERTON, WA, 98310, UNITED STATES

Name

Role

Address

JANET VONDRAN

Governing Person

2528 WHEATON WAY STE #204, BREMERTON, WA, 98310, UNITED STATES

MIKE JACKSON

Governing Person

2528 WHEATON WAY STE #204, BREMERTON, WA, 98310, UNITED STATES

National Provider Identifier

NPI Number:

1427474790

Link:

View on NPI website

Authorized Person:

Name:

CHERYL SILVES

Role:

OFFICE MANAGER

Phone:

3606279219

Taxonomy:

Selected Taxonomy:

363LP0808X - Psychiatric/Mental Health Nurse Practitioner

Is Primary:

Selected Taxonomy:

2084P0805X - Geriatric Psychiatry Physician

Is Primary:

Yes

Contacts:

Fax:

3606279288

Fax:

3696279288

NORTHWEST PSYCHIATRY, INC., P.S.

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Registered Agent Information

Key Officers & Management

National Provider Identifier

Authorized Person:

Taxonomy:

Contacts:

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