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OVERLAKE MEDICAL CLINICS, LLC

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Company Details

Legal Name: OVERLAKE MEDICAL CLINICS, LLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: October 20th 1998
Expiration date: 31 Oct 2025
UBI Number: 601 908 312
ZIP code: 98004
City: Bellevue
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 1035 116TH AVE NE, BELLEVUE, WA, 98004-4604, UNITED STATES
Supporting healthcare providers fighting with COVID-19: $872,575

Contact Details

E-Mail: CORPORATE@OMWLAW.COM

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role
OMW R.A. SERVICES, LLC Registered Agent

Key Officers & Management

Name Role
VALERIE CHRUSCIEL Governing Person
KELAN KOENIG, MD Governing Person

National Provider Identifier

NPI Number:
1871745703

Authorized Person:

Name:
DAVID SCHULTZ
Role:
COO
Phone:

Taxonomy:

Selected Taxonomy:
174400000X - Specialist
Is Primary:
Yes

Contacts:

Fax:
4256885605
Fax:
4256885756
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