PAIN CONSULTANTS OF WASHINGTON PLLC

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Company Details

Legal Name:	PAIN CONSULTANTS OF WASHINGTON PLLC
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Administratively Dissolved
Formation/ Registration Date:	April 15th 2002
Date of Dissolution:	September 3rd 2020
Expiration date:	30 Apr 2020
UBI Number:	602 197 976
ZIP code:	98296
City:	Snohomish
County:	SNOHOMISH
Home State:	WASHINGTON
Principal Office Street Address:	20603 127TH AVE SE, SNOHOMISH, WA, 98296-3937, UNITED STATES

Contact Details

E-Mail:	BERNADETTENELSON@FRONTIER.COM
Phone Number:	+1 425-765-2988

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name	Role	Address
BERNADETTE NELSON	Registered Agent	20603 127 AVE SE, SNOHOMISH, WA, 98296-0000, UNITED STATES

Key Officers & Management

Name	Role	Address
DANIEL NELSON	Governing Person	20603 127TH AVE SE, KIRKLAND, WA, 98033, UNITED STATES
BERNADETTE NELSON	Governing Person	20603 127 AVE SE, SNOHOMISH, WA, 98296, UNITED STATES

National Provider Identifier

NPI Number:

1437189818

Link:

View on NPI website

Authorized Person:

Name:

MRS. BERNADETTE M NELSON

Role:

OPERATIONS MANAGER

Phone:

4258996030

Taxonomy:

Selected Taxonomy:

208VP0014X - Interventional Pain Medicine Physician

Is Primary:

Yes

Contacts:

Phone:

+1 425-899-6030

Fax:

4258996031

Form 5500 Series

Employer Identification Number (EIN):

010670144

Plan Year:

2016

Number Of Participants:

16

Sponsor's telephone number:

4258996030

File:

Plan Year:

2015

Number Of Participants:

16

Sponsor's telephone number:

4258996030

File:

Plan Year:

2014

Number Of Participants:

13

Sponsor's telephone number:

4258996030

File:

Plan Administrator / Signatory:

DANIEL NELSON(Plan administrator)

Plan Year:

2013

Number Of Participants:

13

Sponsor's telephone number:

4258996030

File:

Plan Administrator / Signatory:

DANIEL NELSON(Plan administrator)

Plan Year:

2012

Number Of Participants:

13

Sponsor's telephone number:

4258996030

File:

Plan Administrator / Signatory:

DANIEL NELSON(Plan administrator)

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