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PALOUSE MEDICAL, P.S.

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Company Details

Legal Name: PALOUSE MEDICAL, P.S.
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL SERVICE CORPORATION
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: October 7th 1975
Date of Dissolution: March 3rd 2025
Expiration date: 31 Oct 2024
UBI Number: 600 175 616
ZIP code: 99163
City: Pullman
County: WHITMAN
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 825 SE BISHOP BLVD STE 200, PULLMAN, WA, 99163-5537, UNITED STATES

Contact Details

E-Mail: TKWATE@PALOUSEMEDICAL.COM
Phone Number: +1 509-332-2517

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
THERESA KWATE Registered Agent 825 SE BISHOP BLVD STE # 200, PULLMAN, WA, 99163-0000, UNITED STATES

Key Officers & Management

Name Role
DENNIS SIMPSON Governing Person
STEPHEN HALL Governing Person
STEPHANIE FOSBACK Governing Person

Links between entities

Type:
Headquarter of
Company Number:
255712
State:
IDAHO

National Provider Identifier

NPI Number:
1548299696
Certification Date:
2023-08-17

Authorized Person:

Name:
DR. STEPHANIE M FOSBACK
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No
Selected Taxonomy:
207RG0100X - Gastroenterology Physician
Is Primary:
No
Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
5093349247

Form 5500 Series

Employer Identification Number (EIN):
910940515
Plan Year:
2023
Number Of Participants:
62
Plan Name:
401(K)
Sponsor's telephone number:
Plan Year:
2022
Number Of Participants:
68
Plan Name:
401(K)
Sponsor's telephone number:
Plan Year:
2021
Number Of Participants:
66
Plan Name:
401(K)
Sponsor's telephone number:
Plan Year:
2020
Number Of Participants:
61
Plan Name:
401(K)
Sponsor's telephone number:
Plan Year:
2019
Number Of Participants:
56
Plan Name:
401(K)
Sponsor's telephone number:

Paycheck Protection Program

Jobs Reported:
65
Initial Approval Amount:
$627,347
Date Approved:
2020-04-14
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$627,347
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$633,550.76
Servicing Lender:
U.S. Bank, National Association
Use of Proceeds:
Payroll: $627,347

Labor Condition Applications

Case Number:
I-200-13294-461753
Program:
H-1B
Job Title:
PHYSICIAN
SOC (ONET/OES) code:
29-1063
SOC (ONET/OES) occupation title:
Internists, General
Begin Date:
2014-04-01
End Date:
2017-04-01

Employment and Wage Information

Address:
PULLMAN, WA
Wage Rate Paid to Nonimmigrant Workers:
$180,000
Per:
Year
Prevailing Wage Rate:
$154,398
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