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PACIFIC SPINE CENTER, PLLC

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Company Details

Legal Name: PACIFIC SPINE CENTER, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Voluntarily Dissolved
Formation/ Registration Date: March 13th 2013
Date of Dissolution: March 25th 2021
Expiration date: 31 Mar 2021
UBI Number: 603 284 526
ZIP code: 98408
City: Tacoma
County: PIERCE
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 7817 PACIFIC AVE, TACOMA, WA, 98408-7028, UNITED STATES
Principal Office Mailing Address: Google Maps Logo 8704 RAINIER AVE S, SEATTLE, WA, 98118, UNITED STATES

Contact Details

E-Mail: DRLU02@GMAIL.COM
Phone Number: +1 206-853-5561

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
DAT LU Registered Agent 8704 RAINIER AVENUE S, SEATTLE, WA, 98118-0000, UNITED STATES

Key Officers & Management

Name Role Address
DAT LU Governing Person 9954 RAINIER AVE SOUTH, SEATTLE, WA, 98118, UNITED STATES
MYTHU CHIEM Governing Person 8404 RAINIER AVE S, SEATTLE, SEATTLE, WA, 98118, UNITED STATES

National Provider Identifier

NPI Number:
1750725677

Authorized Person:

Name:
ALLYSA TAYLOR
Role:
LMP
Phone:

Taxonomy:

Selected Taxonomy:
305R00000X - Preferred Provider Organization
Is Primary:
Yes

Contacts:

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