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PROVASCULAR DIAGNOSTIC IMAGING, PLLC

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Company Details

Legal Name: PROVASCULAR DIAGNOSTIC IMAGING, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: January 17th 2013
Date of Dissolution: May 5th 2014
Expiration date: 31 Jan 2015
UBI Number: 603 269 065

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Registered Agent Information

Name Role Address
DAVID ELESHNER Registered Agent 800 BELLEVUE WAY NE #400, BELLEVUE, WA, 98004, UNITED STATES

Key Officers & Management

Name Role Address
DENNIS SU MD Governing Person 202 N DIVISION ST STE 200, AUBURN, WA, 98001, UNITED STATES

National Provider Identifier

NPI Number:
1003252776

Authorized Person:

Name:
DENNIS SU
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
2085R0204X - Vascular & Interventional Radiology Physician
Is Primary:
Yes

Contacts:

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