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NORTHWEST SPORTS & SPINE, PLLC

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Company Details

Legal Name: NORTHWEST SPORTS & SPINE, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: May 14th 2002
Date of Dissolution: September 2nd 2014
Expiration date: 31 May 2014
UBI Number: 602 205 384

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Registered Agent Information

Name Role Address
LISA BLISS Registered Agent 15404 E SPRINGFIELD AVE STE, L201, SPOKANE VALLEY, WA, 99037-8569, UNITED STATES

Key Officers & Management

Name Role Address
LISA BLISS Governing Person NORTHWEST SPORTS & SPINE PLLC, 15404 E SPRINGFIELD AVE, L-201, SPOKANE VALLEY, WA, 99037, UNITED STATES

National Provider Identifier

NPI Number:
1528391810

Authorized Person:

Name:
LISA BLISS
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
2081S0010X - Sports Medicine (Physical Medicine & Rehabilitation) Physician
Is Primary:
Yes

Contacts:

Fax:
5096241087
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