PEDIATRICS NORTHWEST, P.S.

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Company Details

Legal Name:	PEDIATRICS NORTHWEST, P.S.
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL SERVICE CORPORATION
Category:	DOMESTIC ENTITY
Status:	Active
Formation/ Registration Date:	December 5th 2000
Expiration date:	31 Dec 2025
UBI Number:	602 082 245
ZIP code:	98405
City:	Tacoma
County:	PIERCE
Home State:	WASHINGTON
Principal Office Street Address:	316 MARTIN L KING JR WAY, STE 212, TACOMA, WA, 98405-4254, UNITED STATES
Principal Office Mailing Address:	PO BOX 1494, TACOMA, WA, 98401-1494, UNITED STATES

Contact Details

E-Mail:	JROGERS@PEDSNW.NET
Phone Number:	+1 216-214-5194

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name	Role	Address
LAWRENCE A LARSON DO	Registered Agent	316 MLK JR WAY #212, TACOMA, WA, 98405-0000, UNITED STATES

Key Officers & Management

Name	Role
LAWRENCE LARSON	Governing Person
IMKA LAVINDER	Governing Person
SARA SCRANTON	Governing Person
REBECCA TAXIER	Governing Person
JULIE YEH	Governing Person
DANIELLE COLEMAN	Governing Person

National Provider Identifier

NPI Number:

1497841571

Link:

View on NPI website

Authorized Person:

Name:

LAWRENCE A LARSON

Role:

PRESIDENT

Phone:

2533835777

Taxonomy:

Selected Taxonomy:

208000000X - Pediatrics Physician

Is Primary:

Yes

Contacts:

Phone:

+1 253-383-5777

Fax:

2533835320

Fax:

2536270855

Form 5500 Series

Employer Identification Number (EIN):

912089965

Plan Year:

2021

Number Of Participants:

113

Plan Name:

401(K)

Sponsor's telephone number:

2533835777

File:

Plan Year:

2020

Number Of Participants:

113

Plan Name:

401(K)

Sponsor's telephone number:

2533835777

File:

Plan Year:

2019

Number Of Participants:

109

Plan Name:

401(K)

Sponsor's telephone number:

2533835777

File:

Plan Administrator / Signatory:

JOSH RICKER(Plan administrator)

Plan Year:

2018

Number Of Participants:

107

Plan Name:

401(K)

Sponsor's telephone number:

2533835777

File:

Plan Administrator / Signatory:

DIANE TANIGUCHI(Plan administrator)

Plan Year:

2017

Number Of Participants:

100

Plan Name:

401(K)

Sponsor's telephone number:

2533835777

File:

Plan Administrator / Signatory:

DIANE TANIGUCHI(Plan administrator)

Paycheck Protection Program

Jobs Reported:

120

Initial Approval Amount:

$1,346,960

Date Approved:

2020-04-28

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$1,346,960

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$1,359,359.41

Servicing Lender:

Customers Bank

Use of Proceeds:

Payroll: $1,346,960

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