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SOAP LAKE FAMILY MEDICINE INC.

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Company Details

Legal Name: SOAP LAKE FAMILY MEDICINE INC.
Jurisdiction: WASHINGTON
Entity Type: WA PROFIT CORPORATION
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: May 16th 2008
Date of Dissolution: September 4th 2012
Expiration date: 31 May 2012
UBI Number: 602 832 941
ZIP code: 98851
City: Soap Lake
County: GRANT
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 127 2ND AVE SW, SOAP LAKE, WA, 98851, UNITED STATES

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Registered Agent Information

Name Role Address
NATIONAL REGISTERED AGENTS, INC. Registered Agent 711 CAPITOL WAY S STE 204, OLYMPIA, WA, 98501-1267, UNITED STATES

Key Officers & Management

Name Role
JOHN BEARUP Governing Person
WALLACE NEWKIRK Governing Person
CANDACE NEWKIRK Governing Person
SUSAN BEARUP Governing Person

National Provider Identifier

NPI Number:
1104013556

Authorized Person:

Name:
MR. JOHN THOMAS BEARUP
Role:
PARTNER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
5092460358
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