SOURCE WELLNESS CENTER, PLLC

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Company Details

Legal Name:	SOURCE WELLNESS CENTER, PLLC
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Administratively Dissolved
Formation/ Registration Date:	January 27th 2020
Date of Dissolution:	June 3rd 2025
Expiration date:	31 Jan 2025
UBI Number:	604 571 731
ZIP code:	98005
City:	Bellevue
County:	KING
Home State:	WASHINGTON
Principal Office Street Address:	2320 130TH AVE NE STE 110, BELLEVUE, WA, 98005-1752, UNITED STATES

Contact Details

E-Mail:	KAIRAJ@LIVE.COM
Phone Number:	+1 425-533-7320

Nature of Business

Any Lawful Purpose

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Registered Agent Information

Name	Role	Address
ASPEN SERVICES GROUP	Registered Agent	8201 164TH AVE NE STE 200, REDMOND, WA, 98052-7615, UNITED STATES

Key Officers & Management

Name	Role	Address
KAIRA JORGENSEN	Executor	12737 NE BEL RED RD STE 210, BELLEVUE, WA, 98005-2697, UNITED STATES
TROY JORGENSEN	Executor	12737 NE BEL RED RD STE 210, BELLEVUE, WA, 98005-2697, UNITED STATES
KAIRA JORGENSEN	Governing Person	-
TROY JORGENSEN	Governing Person	-

National Provider Identifier

NPI Number:

1447935143

Certification Date:

2023-06-20

Link:

View on NPI website

Authorized Person:

Name:

KAIRA JORGENSEN

Role:

OWNER

Phone:

4255337320

Taxonomy:

Selected Taxonomy:

175F00000X - Naturopath

Is Primary:

Selected Taxonomy:

171100000X - Acupuncturist

Is Primary:

Yes

Contacts:

Phone:

+1 425-533-7320

Paycheck Protection Program

Jobs Reported:

Initial Approval Amount:

$10,210

Date Approved:

2021-05-01

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$20,832

Race:

White

Ethnicity:

Not Hispanic or Latino

Gender:

Female Owned

Veteran:

Non-Veteran

Forgiveness Amount:

$21,160.68

Servicing Lender:

U.S. Bank, National Association

Use of Proceeds:

Payroll: $20,829
Utilities: $1

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