NORTHWEST SKIN SPECIALISTS, PLLC

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Company Details

Legal Name:	NORTHWEST SKIN SPECIALISTS, PLLC
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Voluntarily Dissolved
Formation/ Registration Date:	February 25th 2004
Date of Dissolution:	August 26th 2021
Expiration date:	28 Feb 2022
UBI Number:	602 370 230
ZIP code:	98104
City:	Seattle
County:	KING
Home State:	WASHINGTON
Principal Office Street Address:	1229 MADISON ST STE 1290, SEATTLE, WA, 98104-3568, UNITED STATES
Supporting healthcare providers fighting with COVID-19:	$34,068

Contact Details

E-Mail:	VRUSSELL@NWSKIN.COM
Phone Number:	+1 206-315-4603

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name	Role	Address
AMY SARKIE	Registered Agent	1229 MADISON STE 1290, SEATTLE, WA, 98104-0000, UNITED STATES

Key Officers & Management

Name	Role	Address
AMY SARKIE	Governing Person	13955 219TH AVE NE, WOODINVILLE, WA, 98077, UNITED STATES
DIANNE THOMPSON	Governing Person	-
DIANNE THOMPSON	EXECUTOR	3600 W LAURELHURST DR NE, SEATTLE, WA, 98105, UNITED STATES
AMY SARKIE	EXECUTOR	13955 219TH AVE NE, WOODINVILLE, WA, 98077, UNITED STATES

National Provider Identifier

NPI Number:

1437154911

Link:

View on NPI website

Authorized Person:

Name:

DIANNE B THOMPSON

Role:

MEDICAL DIRECTOR, OWNER MEMBER

Phone:

2063154603

Taxonomy:

Selected Taxonomy:

207N00000X - Dermatology Physician

Is Primary:

Yes

Contacts:

Phone:

+1 206-315-4603

Fax:

2063154601

Form 5500 Series

Employer Identification Number (EIN):

200682860

Plan Year:

2019

Number Of Participants:

25

Plan Name:

401(K)

Sponsor's telephone number:

2063154603

File:

Plan Administrator / Signatory:

AMY SARKIE(Plan administrator)

Plan Year:

2019

Number Of Participants:

23

Plan Name:

401(K)

Sponsor's telephone number:

2063154603

File:

Plan Administrator / Signatory:

AMY SARKIE(Plan administrator)

Plan Year:

2018

Number Of Participants:

21

Plan Name:

401(K)

Sponsor's telephone number:

2063154603

File:

Plan Administrator / Signatory:

AMY SARKIE(Plan administrator)

Plan Year:

2017

Number Of Participants:

24

Plan Name:

401(K)

Sponsor's telephone number:

2063154603

File:

Plan Administrator / Signatory:

AMY SARKIE(Plan administrator)

Plan Year:

2016

Number Of Participants:

23

Plan Name:

401(K)

Sponsor's telephone number:

2063154603

File:

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