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PACIFIC MEDICAL SPECIALTY GROUP, LLC

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Company Details

Legal Name: PACIFIC MEDICAL SPECIALTY GROUP, LLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: December 7th 2021
Expiration date: 31 Dec 2026
UBI Number: 604 837 383
ZIP code: 98402
City: Tacoma
County: PIERCE
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 917 PACIFIC AVE STE 600,, SUITE 600, 100, TACOMA, WA, 98402-4437, UNITED STATES

Contact Details

E-Mail: WAYNE@PACMSG.COM
Phone Number: +1 253-310-2236

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role
PACIFIC MEDICAL SPECIALTY GROUP, LLC Registered Agent

Key Officers & Management

Name Role Address
BRENDA EVANS Executor 1117 W YOUNG ST, ELMA, WA, 98541-9090, UNITED STATES
BRENDA EVANS Governing Person 4025 157TH ST NW, GIG HARBOR, WA, 98332-9071, UNITED STATES
WAYNE MANNIE Governing Person -

Links between entities

Type:
Headquarter of
Company Number:
10256956
State:
ALASKA
Type:
Headquarter of
Company Number:
5730725
State:
IDAHO

National Provider Identifier

NPI Number:
1548911811
Certification Date:
2022-03-14

Authorized Person:

Name:
STANLEY FLEMMING
Role:
CMO
Phone:

Taxonomy:

Selected Taxonomy:
261QM1300X - Multi-Specialty Clinic/Center
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
873782084
Plan Year:
2023
Number Of Participants:
0
Plan Name:
401(K)
Sponsor's telephone number:
Plan Administrator / Signatory:
WAYNE MANNIE(Plan administrator)
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