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PACIFIC MENTAL HEALTH LLC

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Company Details

Legal Name: PACIFIC MENTAL HEALTH LLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: October 16th 2018
Expiration date: 31 Oct 2025
UBI Number: 603 422 873
ZIP code: 98036
City: Lynnwood
County: SNOHOMISH
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 5108 196TH ST SW STE 350, LYNNWOOD, WA, 98036-6169, UNITED STATES

Contact Details

E-Mail: BILLING@PACMH.ORG

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role
PACIFIC MENTAL HEALTH LLC Registered Agent

Key Officers & Management

Name Role Address
JEFFERY GOFF Executor 5108 196TH ST SW STE 350, LYNNWOOD, WA, 98036-6169, UNITED STATES
JEFFERY GOFF Governing Person 5108 196TH ST SW STE 350, LYNNWOOD, WA, 98036-6169, UNITED STATES

National Provider Identifier

NPI Number:
1255987368
Certification Date:
2025-03-12

Authorized Person:

Name:
JEANETTE ELIASSEN
Role:
BILLING SPECIALIST
Phone:

Taxonomy:

Selected Taxonomy:
101YM0800X - Mental Health Counselor
Is Primary:
Yes

Contacts:

Fax:
8886416642

Form 5500 Series

Employer Identification Number (EIN):
832210353
Plan Year:
2023
Number Of Participants:
39
Plan Name:
401(K)
Sponsor's telephone number:
Plan Administrator / Signatory:
JEFFERY GOFF(Plan administrator)
Plan Year:
2022
Number Of Participants:
23
Plan Name:
401(K)
Sponsor's telephone number:
Plan Administrator / Signatory:
JEFFERY GOFF(Plan administrator)
Plan Year:
2021
Number Of Participants:
16
Plan Name:
401(K)
Sponsor's telephone number:
Plan Administrator / Signatory:
JEFFERY GOFF(Plan administrator)
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