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OVERLAKE BREAST IMAGING, L.L.C.

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Company Details

Legal Name: OVERLAKE BREAST IMAGING, L.L.C.
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: October 14th 2005
Date of Dissolution: February 1st 2016
Expiration date: 31 Oct 2015
UBI Number: 602 548 315
ZIP code: 98004
City: Bellevue
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 1305 116TH AVE NE, BELLEVUE, WA, 98004, UNITED STATES

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Registered Agent Information

Name Role Address
MARK JONES Registered Agent 17822 NE 154TH ST, WOODINVILLE, WA, 98072-6378, UNITED STATES

Key Officers & Management

Name Role Address
PATRIC WIESMANN Governing Person 16425 NE 169TH PL, WOODINVILLE, WA, 98072, UNITED STATES
MARK JONES Governing Person 17822 NE 154TH ST, WOODINVILLE, WA, 98072, UNITED STATES

National Provider Identifier

NPI Number:
1003985060

Authorized Person:

Name:
MARK P JONES
Role:
CO-MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
261QR0200X - Radiology Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
4257717929
Fax:
4252131336
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