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PRISMA WELLNESS, PLLC

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Company Details

Legal Name: PRISMA WELLNESS, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: January 1st 2020
Expiration date: 31 Jan 2026
UBI Number: 604 536 212
ZIP code: 98057
City: Renton
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 321 BURNETT AVE S FL 2, RENTON, WA, 98057-2558, UNITED STATES

Contact Details

E-Mail: INFO@PRISMAWELLNESS.COM
Phone Number: +1 206-785-1015

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role
PRISMA WELLNESS, PLLC Registered Agent

Key Officers & Management

Name Role Address
SCOTT WIENER Executor 901 BOREN AVE, SUITE 702, SEATTLE, WA, 98104-3301, UNITED STATES
SCOTT WIENER Governing Person -
DANIELA BORQUEZ Governing Person -

National Provider Identifier

NPI Number:
1093351496
Certification Date:
2024-10-10

Authorized Person:

Name:
DR. SCOTT WIENER
Role:
CHIEF MEDICAL OFFICER
Phone:

Taxonomy:

Selected Taxonomy:
2084P0800X - Psychiatry Physician
Is Primary:
Yes

Contacts:

Fax:
2067851023

Form 5500 Series

Employer Identification Number (EIN):
843688679
Plan Year:
2023
Number Of Participants:
4
Plan Name:
401(K)
Sponsor's telephone number:
Plan Administrator / Signatory:
DANIELA BORQUEZ(Plan administrator)
Plan Year:
2022
Number Of Participants:
3
Plan Name:
401(K)
Sponsor's telephone number:
Plan Administrator / Signatory:
DANIELA BORQUEZ(Plan administrator)
Plan Year:
2021
Number Of Participants:
2
Sponsor's telephone number:
Plan Administrator / Signatory:
DANI BORQUEZ(Plan administrator)
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