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SELAH VISION SOURCE, PLLC

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Company Details

Legal Name: SELAH VISION SOURCE, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: April 16th 2007
Date of Dissolution: March 27th 2015
Expiration date: 30 Apr 2015
UBI Number: 602 716 903

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Registered Agent Information

Name Role Address
DALE KGRAF OD Registered Agent 105 W ORCHARD AVE, SELAH, WA, 98942, UNITED STATES

Key Officers & Management

Name Role Address
DALE K GRAF OD Governing Person 105 W ORCHARD AVE, SELAH, WA, 98942, UNITED STATES
NANCY GRAF Governing Person 105 W ORCHARD AVE, SELAH, WA, 98942, UNITED STATES

National Provider Identifier

NPI Number:
1487787511

Authorized Person:

Name:
MRS. NANCY S GRAF
Role:
PROJECTS MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
152W00000X - Optometrist
Is Primary:
Yes

Contacts:

Fax:
5096976659
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