PROSTATE CANCER CENTER OF SEATTLE, PLLC

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Company Details

Legal Name:	PROSTATE CANCER CENTER OF SEATTLE, PLLC
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Administratively Dissolved
Formation/ Registration Date:	December 17th 2008
Date of Dissolution:	May 1st 2017
Expiration date:	31 Dec 2016
UBI Number:	602 885 512
ZIP code:	98115
City:	Seattle
County:	KING
Home State:	WASHINGTON
Principal Office Street Address:	9730 3RD AVE NE STE 208, SEATTLE, WA, 98115, UNITED STATES

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Key Officers & Management

Name	Role	Address
PETER GRIMM	Governing Person	9730 THIRD AVE NE STE 208, SEATTLE, WA, 98115, UNITED STATES

National Provider Identifier

NPI Number:

1013144617

Link:

View on NPI website

Authorized Person:

Name:

DR. PETER D GRIMM

Role:

MEMBER

Phone:

2063284215

Taxonomy:

Selected Taxonomy:

2085R0001X - Radiation Oncology Physician

Is Primary:

Yes

Contacts:

Phone:

+1 206-453-2992

Form 5500 Series

Employer Identification Number (EIN):

264095976

Plan Year:

2016

Number Of Participants:

12

Plan Name:

401(K)

Sponsor's telephone number:

2064532992

File:

Plan Year:

2016

Number Of Participants:

2

Plan Name:

401(K)

Sponsor's telephone number:

2064532992

File:

Plan Year:

2015

Number Of Participants:

13

Plan Name:

401(K)

Sponsor's telephone number:

2064532992

File:

Plan Year:

2014

Number Of Participants:

12

Plan Name:

401(K)

Sponsor's telephone number:

2064532992

File:

Plan Administrator / Signatory:

PETER GRIMM(Plan administrator)

Plan Year:

2013

Number Of Participants:

8

Plan Name:

RETIREMENT PLAN

Sponsor's telephone number:

2064532992

File:

Plan Administrator / Signatory:

PETER GRIMM(Plan administrator)

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