OLYMPIC SPORTS & SPINE REHABILITATION, P.S.

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Company Details

Legal Name:	OLYMPIC SPORTS & SPINE REHABILITATION, P.S.
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFIT CORPORATION
Category:	DOMESTIC ENTITY
Status:	Active
Formation/ Registration Date:	June 27th 1985
Expiration date:	30 Jun 2026
UBI Number:	600 597 979
ZIP code:	98409
City:	Tacoma
County:	PIERCE
Home State:	WASHINGTON
Principal Office Street Address:	6050 TACOMA MALL BLVD, STE 300, TACOMA, WA, 98409, UNITED STATES

Contact Details

E-Mail:	BROWLAND@OSSTHERAPY.COM
Phone Number:	+1 253-581-5200

Nature of Business

Health Care, Social Assistance & Service Organization, Administration & Business Support Services

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Registered Agent Information

Name	Role	Address
BRIAN GREEN	Registered Agent	1102 BROADWAY STE 500, TACOMA, WA, 98402-3534, UNITED STATES

Key Officers & Management

Name	Role	Address
BRIAN THACKER	Governing Person	9315 GRAVELLY LAKE DR SW #306, LAKEWOOD, WA, 98499, UNITED STATES
CLAUDE CIANCIO	Governing Person	-

National Provider Identifier

NPI Number:

1144685306

Link:

View on NPI website

Authorized Person:

Name:

BRIAN THACKER

Role:

VICE PRESIDENT

Phone:

2535815200

Taxonomy:

Selected Taxonomy:

225700000X - Massage Therapist

Is Primary:

No

Selected Taxonomy:

225X00000X - Occupational Therapist

Is Primary:

No

Selected Taxonomy:

332B00000X - Durable Medical Equipment & Medical Supplies

Is Primary:

No

Selected Taxonomy:

225100000X - Physical Therapist

Is Primary:

Yes

Contacts:

Phone:

+1 253-581-5200

Fax:

2535815203

Phone:

+1 253-864-7595

Fax:

2538640457

Form 5500 Series

Employer Identification Number (EIN):

911299625

Plan Year:

2017

Number Of Participants:

70

Plan Name:

401(K)

Sponsor's telephone number:

2535815200

File:

Plan Year:

2016

Number Of Participants:

59

Plan Name:

401(K)

Sponsor's telephone number:

2535815200

File:

Plan Year:

2015

Number Of Participants:

62

Plan Name:

401(K)

Sponsor's telephone number:

2535815200

File:

Plan Year:

2014

Number Of Participants:

60

Plan Name:

401(K)

Sponsor's telephone number:

2535815200

File:

Plan Administrator / Signatory:

VERN ESSENBERG(Plan administrator)

Plan Year:

2013

Number Of Participants:

55

Plan Name:

401(K)

Sponsor's telephone number:

2535815200

File:

Plan Administrator / Signatory:

VERN ESSENBERG(Plan administrator)

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