PUGET SOUND PHYSICIANS, PLLC

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Company Details

Legal Name:	PUGET SOUND PHYSICIANS, PLLC
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Active
Formation/ Registration Date:	July 13th 1995
Expiration date:	31 Jul 2026
UBI Number:	601 643 593
ZIP code:	98004
City:	Bellevue
County:	KING
Home State:	WASHINGTON
Principal Office Street Address:	1035 116TH AVE NE, BELLEVUE, WA, 98004-4604, UNITED STATES
Supporting healthcare providers fighting with COVID-19:	$489,711

Contact Details

E-Mail:	PSPADMIN@OVERLAKEHOSPITAL.ORG
Phone Number:	+1 425-688-5645

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name	Role	Address
PUGET SOUND PHYSICIANS, PLLC	Registered Agent	1035 116TH AVE NE, BELLEVUE, WA, 98004-4604, UNITED STATES

Key Officers & Management

Name	Role
ERIC SHIPLEY	Governing Person

Unique Entity ID

Unique Entity ID:

JY9SRNGGCWX5

CAGE Code:

07B74

UEI Expiration Date:

2025-10-16

Business Information

URL:

https://www.pugetsoundphysicians.com/

Division Name:

PUGET SOUND PHYSICIANS, PLLC

Activation Date:

2024-10-23

Initial Registration Date:

2024-10-16

National Provider Identifier

NPI Number:

1801900501

Link:

View on NPI website

Authorized Person:

Name:

SHELLI I PEREIRA

Role:

CHIEF FINANCIAL OFFICER

Phone:

4256885759

Taxonomy:

Selected Taxonomy:

207P00000X - Emergency Medicine Physician

Is Primary:

Yes

Contacts:

Phone:

+1 425-688-5759

Fax:

4256885101

Form 5500 Series

Employer Identification Number (EIN):

911692040

Plan Year:

2023

Number Of Participants:

58

Plan Name:

401(K)

Sponsor's telephone number:

4256885759

File:

Plan Administrator / Signatory:

ERIC R. SHIPLEY M.D.(Plan administrator) ERIC R. SHIPLEY M.D.(Employer/plan sponsor)

Plan Year:

2022

Number Of Participants:

46

Plan Name:

401(K)

Sponsor's telephone number:

4256885759

File:

Plan Administrator / Signatory:

ERIC R. SHIPLEY M.D.(Plan administrator) ERIC R. SHIPLEY M.D.(Employer/plan sponsor)

Plan Year:

2021

Number Of Participants:

44

Plan Name:

401(K)

Sponsor's telephone number:

4256885759

File:

Plan Administrator / Signatory:

ERIC R. SHIPLEY M.D.(Plan administrator) ERIC R. SHIPLEY M.D.(Employer/plan sponsor)

Plan Year:

2020

Number Of Participants:

40

Plan Name:

401(K)

Sponsor's telephone number:

4256885759

File:

Plan Administrator / Signatory:

ERIC R. SHIPLEY M.D.(Plan administrator) ERIC R. SHIPLEY M.D.(Employer/plan sponsor)

Plan Year:

2019

Number Of Participants:

40

Plan Name:

401(K)

Sponsor's telephone number:

4256885759

File:

Plan Administrator / Signatory:

ERIC R. SHIPLEY M.D.(Plan administrator) ERIC R. SHIPLEY M.D.(Employer/plan sponsor)

Paycheck Protection Program

Jobs Reported:

43

Initial Approval Amount:

$821,900

Date Approved:

2020-04-10

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$821,900

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$832,663.51

Servicing Lender:

KeyBank National Association

Use of Proceeds:

Payroll: $821,900

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