OVERLAKE IMAGING ASSOCIATES, P.C.

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Company Details

Legal Name:	OVERLAKE IMAGING ASSOCIATES, P.C.
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL SERVICE CORPORATION
Category:	DOMESTIC ENTITY
Status:	Voluntarily Dissolved
Formation/ Registration Date:	June 5th 1996
Date of Dissolution:	December 29th 2016
Expiration date:	30 Jun 2017
UBI Number:	601 717 774
ZIP code:	98004
City:	Bellevue
County:	KING
Home State:	WASHINGTON
Principal Office Street Address:	1659 104TH AVE SE, BELLEVUE, WA, 98004, UNITED STATES

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Registered Agent Information

Name	Role	Address
DAVID T HASBROOK	Registered Agent	1659 104TH AVE SE, BELLEVUE, WA, 98004-7126, UNITED STATES

Key Officers & Management

Name	Role	Address
DIANE GALLIETT	Governing Person	1417 116TH AVE NE, SUITE 212, BELLEVUE, WA, 98004, UNITED STATES
HAROLD PROW	Governing Person	1417 116TH AVE NE, SUITE 212, BELLEVUE, WA, 98004, UNITED STATES
FRANTZ PIERRE-JEROME	Governing Person	1417 116TH AVE NE, SUITE 212, BELLEVUE, WA, 98004, UNITED STATES
JOHN CLEMETT	Governing Person	1417 116TH AVE NE, SUITE 212, BELLEVUE, WA, 98004, UNITED STATES

National Provider Identifier

NPI Number:

1902870827

Link:

View on NPI website

Authorized Person:

Name:

MARK J PFLEGER

Role:

PRESIDENT

Phone:

4255028362

Taxonomy:

Selected Taxonomy:

2085R0204X - Vascular & Interventional Radiology Physician

Is Primary:

No

Selected Taxonomy:

2085R0202X - Diagnostic Radiology Physician

Is Primary:

Yes

Contacts:

Phone:

+1 877-556-1057

Fax:

8005084751

Phone:

+1 425-502-8362

Form 5500 Series

Employer Identification Number (EIN):

911734262

Plan Year:

2015

Number Of Participants:

19

Plan Name:

401(K)

Sponsor's telephone number:

4255028362

File:

Plan Administrator / Signatory:

TESSA NESKE(Plan administrator)

Plan Year:

2015

Number Of Participants:

15

Plan Name:

401(K)

Sponsor's telephone number:

4255028362

File:

Plan Administrator / Signatory:

TESSA NESKE(Plan administrator)

Plan Year:

2014

Number Of Participants:

18

Plan Name:

401(K)

Sponsor's telephone number:

4255028362

File:

Plan Administrator / Signatory:

TESSA NESKE(Plan administrator)

Plan Year:

2013

Number Of Participants:

21

Plan Name:

401(K)

Sponsor's telephone number:

4255028362

File:

Plan Administrator / Signatory:

TESSA NESKE(Plan administrator)

Plan Year:

2012

Number Of Participants:

55

Plan Name:

401(K)

Sponsor's telephone number:

4255028362

File:

Plan Administrator / Signatory:

SHERRY WILLIAMS(Plan administrator)

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