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PHILLIPS FAMILY MEDICINE & WELLNESS, PLLC

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Company Details

Legal Name: PHILLIPS FAMILY MEDICINE & WELLNESS, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: February 24th 2025
Expiration date: 28 Feb 2026
UBI Number: 605 760 004
ZIP code: 98003
City: Federal Way
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 1045 S 320TH ST, FEDERAL WAY, WA, 98003-5179, UNITED STATES

Contact Details

E-Mail: PRUDENTMEDICALNW@GMAIL.COM

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Registered Agent Information

Name Role
UNITED STATES CORPORATION AGENTS, INC. Registered Agent

Key Officers & Management

Name Role Address
JEREMY PHILLIPS Executor 1045 S 320TH ST, FEDERAL WAY, WA, 98003-5179, UNITED STATES

National Provider Identifier

NPI Number:
1215734876
Certification Date:
2025-02-28

Authorized Person:

Name:
JEREMY PHILLIPS
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261Q00000X - Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2534997988
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