OLYMPIA EYE CLINIC, PLLC

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Company Details

Legal Name:	OLYMPIA EYE CLINIC, PLLC
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Active
Formation/ Registration Date:	February 2nd 1970
Expiration date:	28 Feb 2026
UBI Number:	600 018 133
Home State:	CALIFORNIA
Principal Office Street Address:	75 ENTERPRISE, SUITE 200, ALISO VIJO, CA, 92656, UNITED STATES

Contact Details

E-Mail:	CLS-CTARMSEVIDENCE@WOLTERSKLUWER.COM
Phone Number:	+1 877-888-1245

Nature of Business

HEALTHCARE.

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Registered Agent Information

Name	Role	Address
RODGER BODOIA	Registered Agent	215 LILLY RD NE, OLYMPIA, WA, 98506-5030, UNITED STATES

Key Officers & Management

Name	Role
GREG CUNNIFF	Governing Person
CHRIS KARKENNY	Governing Person

National Provider Identifier

NPI Number:

1780845826

Certification Date:

2020-02-08

Link:

View on NPI website

Authorized Person:

Name:

RODGER D BODOIA

Role:

PRESIDENT

Phone:

3604564800

Taxonomy:

Selected Taxonomy:

261QA1903X - Ambulatory Surgical Clinic/Center

Is Primary:

Yes

Contacts:

Phone:

+1 360-456-4800

Form 5500 Series

Employer Identification Number (EIN):

941715932

Plan Year:

2021

Number Of Participants:

16

Plan Name:

401(K)

Sponsor's telephone number:

3604564800

File:

Plan Year:

2021

Number Of Participants:

2

Plan Name:

401(K)

Sponsor's telephone number:

3604564800

File:

Plan Year:

2020

Number Of Participants:

32

Plan Name:

401(K)

Sponsor's telephone number:

3604564800

File:

Plan Year:

2019

Number Of Participants:

35

Plan Name:

401(K)

Sponsor's telephone number:

3604564800

File:

Plan Year:

2018

Number Of Participants:

37

Plan Name:

401(K)

Sponsor's telephone number:

3604564800

File:

Plan Administrator / Signatory:

RODGER D BODOIA(Plan administrator)

History

Type	Old value	New value	Date of change
Name change	OLYMPIA EYE CLINIC, INC. P.S.	OLYMPIA EYE CLINIC, PLLC	2019-07-15

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