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SAND MEDICAL CLINIC PLLC

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Company Details

Legal Name: SAND MEDICAL CLINIC PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: April 16th 2024
Expiration date: 30 Apr 2026
UBI Number: 605 518 291
ZIP code: 98391
City: Bonney Lake
County: PIERCE
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 7720 190TH AVE E, BONNEY LAKE, WA, 98391-7010, UNITED STATES

Contact Details

E-Mail: SANDMEDICALCLINIC@GMAIL.COM
Phone Number: +1 253-374-5183

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
SAMWEL MBUA Registered Agent 7720 190TH AVE E, BONNEY LAKE, WA, 98391-7010, UNITED STATES

Key Officers & Management

Name Role Address
SAMWEL MBUA Executor 7720 190TH AVE E, BONNEY LAKE, WA, 98391-7010, UNITED STATES
SAMWEL MBUA Governing Person 7720 190TH AVE E, BONNEY LAKE, WA, 98391-7010, UNITED STATES

National Provider Identifier

NPI Number:
1407687965
Certification Date:
2024-08-08

Authorized Person:

Name:
SAMWEL MBUA
Role:
GOVERNOR
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

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