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PERIPHERAL NERVE CLINIC, P.S.

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Company Details

Legal Name: PERIPHERAL NERVE CLINIC, P.S.
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL SERVICE CORPORATION
Category: DOMESTIC ENTITY
Status: Voluntarily Dissolved
Formation/ Registration Date: December 6th 2012
Date of Dissolution: March 7th 2018
Expiration date: 31 Dec 2018
UBI Number: 603 257 702

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Registered Agent Information

Name Role Address
EDDIE HANSEN Registered Agent 2004 N STATE ST, BELLINGHAM, WA, 98225-0000, UNITED STATES

Key Officers & Management

Name Role
EDDIE HANSEN Governing Person

National Provider Identifier

NPI Number:
1558606111

Authorized Person:

Name:
EDDIE HANSEN
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
225100000X - Physical Therapist
Is Primary:
No
Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
208D00000X - General Practice Physician
Is Primary:
Yes

Contacts:

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