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PROVIDENCE HEALTH ASSURANCE

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Company Details

Legal Name: PROVIDENCE HEALTH ASSURANCE
Jurisdiction: WASHINGTON
Entity Type: FOREIGN NONPROFIT CORPORATION
Category: FOREIGN ENTITY
Status: Active
Formation/ Registration Date: March 11th 2013
Expiration date: 31 Mar 2026
UBI Number: 603 284 071
Home State: OREGON
Principal Office Street Address: Google Maps Logo 4400 NE HALSEY ST., BUILDING 2, SUITE 698, PORTLAND, OR, 97213, UNITED STATES

Contact Details

E-Mail: CLS-CTARMSEVIDENCE@WOLTERSKLUWER.COM

Nature of Business

HEALTH CARE

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Registered Agent Information

Name Role
C T CORPORATION SYSTEM Registered Agent

Key Officers & Management

Name Role
LINA SAADZOI Governing Person
GREGORY Q. ZAMUDIO Governing Person
MIKE ALEXANDER Governing Person
JOSEPH BLANKENSHIP Governing Person
GRACIELA GOMEZ COWGER Governing Person
DONALD ANTONUCCI Governing Person
KIMBERLEY GOODE Governing Person
RHONDA L. MEDOWS, MD Governing Person
BYRON SCOTT Governing Person
CECILIA SUN Governing Person

Tax Exempt

Employer Identification Number (EIN):
55-0828701
In Care Of Name:
% ACCOUNTING
Ruling Date:
2006-07
National Taxonomy Of Exempt Entities:
Health Care: Group Health Practice (Health Maintenance Organizations)

Copies of Returns

Return Type:
990O
Tax Period:
202212
Link:
Download 990O
Return Type:
990O
Tax Period:
202112
Link:
Download 990O
Return Type:
990O
Tax Period:
202012
Link:
Download 990O

Related by address

4400 NE HALSEY ST., BUILDING 2, SUITE 698, PORTLAND, OR, 97213, UNITED STATES

PROVIDENCE HEALTH PLAN
FOREIGN NONPROFIT CORPORATION - Active
PROVIDENCE PLAN PARTNERS
WA NONPROFIT CORPORATION - Active
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