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PHYSICIAN'S CARE FAMILY MEDICINE, INC., P.S.

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Company Details

Legal Name: PHYSICIAN'S CARE FAMILY MEDICINE, INC., P.S.
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL SERVICE CORPORATION
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: December 1st 1972
Date of Dissolution: May 1st 2017
Expiration date: 31 Dec 2016
UBI Number: 600 088 066

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Registered Agent Information

Name Role Address
HERBERT EDWIN STICKLE Registered Agent 1010 HILLCREST DR, BURLINGTON, WA, 98233-1471, UNITED STATES

Key Officers & Management

Name Role Address
HERBERT STICKLE Governing Person 1010 HILLCREST DRIVE, BURLINGTON, WA, 98233, UNITED STATES
GILSON GIROTTO Governing Person 23853 NOOKACHAMP HILLS DRIVE, MOUNT VERNON, WA, 98274, UNITED STATES
ROBERT JACOBSEN Governing Person 1021 NEZ PERCE DRIVE, MOUNT VERNON, WA, 98273, UNITED STATES
JONATHAN FISH Governing Person 4009 MONTGOMERY COURT, MOUNT VERNON, WA, 98274, UNITED STATES

National Provider Identifier

NPI Number:
1588091045
Link:
View on NPI website

Authorized Person:

Name:
MS. SHERYL CARMAN
Role:
OFFICE MANAGER
Phone:
3608564141

Taxonomy:

Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
Yes

Contacts:

Phone:
+1 360-856-4141
Fax:
3608564145
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