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PORT TOWNSEND PSYCHIATRIC MEDICINE PLLC

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Company Details

Legal Name: PORT TOWNSEND PSYCHIATRIC MEDICINE PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: May 3rd 2018
Expiration date: 31 May 2026
UBI Number: 604 281 582
ZIP code: 98368
City: Port Townsend
County: JEFFERSON
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 1303 WASHINGTON ST, PORT TOWNSEND, WA, 98368-6715, UNITED STATES

Contact Details

E-Mail: PTPSYCHMED@GMAIL.COM
Phone Number: +1 360-385-9818

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role
PORT TOWNSEND PSYCHIATRIC MEDICINE PLLC Registered Agent

Key Officers & Management

Name Role Address
KARI HEISTAND Executor PO BOX 607, PORT TOWNSEND, WA, 98368-0607, UNITED STATES
KARI HEISTAND Governing Person -

National Provider Identifier

NPI Number:
1467016444
Certification Date:
2021-04-29

Authorized Person:

Name:
DR. KARI CASE HEISTAND
Role:
OWNER/PSYCHIATRIST
Phone:

Taxonomy:

Selected Taxonomy:
261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
Is Primary:
Yes

Contacts:

Fax:
3603851496
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