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SEATTLE HEAD, NECK & PLASTIC SURGEONS, PLLC

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Company Details

Legal Name: SEATTLE HEAD, NECK & PLASTIC SURGEONS, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: May 17th 2000
Date of Dissolution: October 2nd 2017
Expiration date: 31 May 2017
UBI Number: 602 037 937

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Registered Agent Information

Name Role Address
LEE BURDETTE Registered Agent 2101 4TH AVE #1830, SEATTLE, WA, 98121-0000, UNITED STATES

Key Officers & Management

Name Role Address
TUCKER KENNETH Governing Person 515 MINOR AVENUE, SUITE 140, SEATTLE, WA, 98104, UNITED STATES
GREGORY CHAN MD Governing Person 515 MINOR AVENUE, SUITE 140, SEATTLE, WA, 98104, UNITED STATES
CALVIN KNAPP MD Governing Person 515 MINOR AVENUE, SUITE 140, SEATTLE, WA, 98104, UNITED STATES
JOHN BURGOYNE MD Governing Person 515 MINOR AVENUE, SUITE 140, SEATTLE, WA, 98104, UNITED STATES

National Provider Identifier

NPI Number:
1649455734

Authorized Person:

Name:
DEBBIE PERDUE
Role:
ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2066823511
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