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PHOENIX HEALTH & WELLNESS PLLC

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Company Details

Legal Name: PHOENIX HEALTH & WELLNESS PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: October 28th 2020
Expiration date: 31 Oct 2025
UBI Number: 604 671 138
ZIP code: 99208
City: Spokane
County: SPOKANE
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 5920 N BRIDGET ST, SPOKANE, WA, 99208-7062, UNITED STATES

Contact Details

E-Mail: CCARLSON0174@YAHOO.COM

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role
UNITED STATES CORPORATION AGENTS, INC. Registered Agent

Key Officers & Management

Name Role Address
JENNIFER CARLSON Executor 5920 N BRIDGET ST, SPOKANE, WA, 99208-7062, UNITED STATES
JENNIFER CARLSON Governing Person -

National Provider Identifier

NPI Number:
1245989292
Certification Date:
2022-05-25

Authorized Person:

Name:
JENNIFER A CARLSON
Role:
OWNER, PRACTITIONER
Phone:

Taxonomy:

Selected Taxonomy:
302F00000X - Exclusive Provider Organization
Is Primary:
Yes

Contacts:

Fax:
5092323309
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