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PETERSON ORTHOPEDICS PLLC

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Company Details

Legal Name: PETERSON ORTHOPEDICS PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: May 20th 2021
Date of Dissolution: February 14th 2023
Expiration date: 31 May 2022
UBI Number: 604 753 959
ZIP code: 99037
City: Veradale
County: SPOKANE
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 902 S SULLIVAN RD, SPOKANE VLY, WA, 99037-9754, UNITED STATES
Principal Office Mailing Address: Google Maps Logo 17017 E 18TH CT, VERADALE, WA, 99037-8052, UNITED STATES

Contact Details

E-Mail: PETERSON.ORTHO@GMAIL.COM
Phone Number: +1 509-389-7680

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Registered Agent Information

Name Role Address
KERRE GOODELL Registered Agent 17017 E 18TH CT, VERADALE, WA, 99037-8052, UNITED STATES

Key Officers & Management

Name Role Address
SHAUN PETERSON Executor 17017 E 18TH CT, VERADALE, WA, 99037-8052, UNITED STATES

National Provider Identifier

NPI Number:
1831860485
Certification Date:
2021-09-23

Authorized Person:

Name:
DR. SHAUN NATHAN PETERSON
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207X00000X - Orthopaedic Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
5099226648
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