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REVIVE SPA HYDRATION PLLC

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Company Details

Legal Name: REVIVE SPA HYDRATION PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: April 7th 2021
Date of Dissolution: September 3rd 2024
Expiration date: 30 Apr 2024
UBI Number: 604 737 367
ZIP code: 98445
City: Tacoma
County: PIERCE
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 17609 29TH AVENUE CT E, TACOMA, WA, 98445-4622, UNITED STATES
Principal Office Mailing Address: Google Maps Logo 17609 29TH AVENUE CT E, TACOMA, WA, 98445, UNITED STATES

Contact Details

E-Mail: INFO@REVIVESPAHYDRATION.COM
Phone Number: +1 253-592-1954

Nature of Business

Other Services, Health Care, Social Assistance & Service Organization, MOBILE HEALTHCARE/RETAIL HEALTHCARE

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Registered Agent Information

Name Role Address
SECURE ALLIANCE PS Registered Agent 17609 29TH AVENUE CT E, TACOMA, WA, 98445-4622, UNITED STATES

Key Officers & Management

Name Role Address
BETH SCHUBERT Executor 17609 29TH AVENUE CT E, TACOMA, WA, 98445, UNITED STATES
BETH SCHUBERT RN Governing Person -
SECURE ALLIANCE PS LLC Governing Person -

National Provider Identifier

NPI Number:
1326712100
Certification Date:
2021-08-06

Authorized Person:

Name:
MRS. BETH ANN SCHUBERT
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
163WI0500X - Infusion Therapy Registered Nurse
Is Primary:
No
Selected Taxonomy:
163WN1003X - Nutrition Support Registered Nurse
Is Primary:
No
Selected Taxonomy:
261Q00000X - Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QI0500X - Infusion Therapy Clinic/Center
Is Primary:
Yes

Contacts:

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