ORTHOSPORT PHYSICAL THERAPY PLLC

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Company Details

Legal Name:	ORTHOSPORT PHYSICAL THERAPY PLLC
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Administratively Dissolved
Formation/ Registration Date:	May 8th 2003
Date of Dissolution:	October 3rd 2018
Expiration date:	31 May 2018
UBI Number:	602 294 283

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Registered Agent Information

Name	Role	Address
THOMAS DIANGELIS	Registered Agent	19217 36TH AVE W STE 102, LYNNWOOD, WA, 98036-0000, UNITED STATES

Key Officers & Management

Name	Role	Address
THOMAS DIANGELIS	Governing Person	19217 36TH AVE W, BLDG 5-102, LYNNWOOD, WA, 98036, UNITED STATES

National Provider Identifier

NPI Number:

1750471538

Link:

View on NPI website

Authorized Person:

Name:

THOMAS DIANGELIS

Role:

OWNER

Phone:

4256709991

Taxonomy:

Selected Taxonomy:

208100000X - Physical Medicine & Rehabilitation Physician

Is Primary:

No

Selected Taxonomy:

208100000X - Physical Medicine & Rehabilitation Physician

Is Primary:

Yes

Contacts:

Phone:

+1 425-670-9991

Fax:

4256709995

Form 5500 Series

Employer Identification Number (EIN):

562354923

Plan Year:

2018

Number Of Participants:

21

Plan Name:

401(K)

Sponsor's telephone number:

4256709991

File:

Plan Year:

2017

Number Of Participants:

19

Plan Name:

401(K)

Sponsor's telephone number:

4256709991

File:

Plan Year:

2016

Number Of Participants:

26

Plan Name:

401(K)

Sponsor's telephone number:

4256709991

File:

Plan Administrator / Signatory:

TOM DIANGELIS(Plan administrator)

Plan Year:

2015

Number Of Participants:

23

Plan Name:

401(K)

Sponsor's telephone number:

4256709991

File:

Plan Administrator / Signatory:

TOM DIANGELIS(Plan administrator)

Plan Year:

2014

Number Of Participants:

27

Sponsor's telephone number:

4256709991

File:

Plan Administrator / Signatory:

TOM DIANGELIS(Plan administrator)

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