SPOKANE VALLEY FAMILY MEDICINE, P.S.

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Company Details

Legal Name:	SPOKANE VALLEY FAMILY MEDICINE, P.S.
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL SERVICE CORPORATION
Category:	DOMESTIC ENTITY
Status:	Administratively Dissolved
Formation/ Registration Date:	December 26th 1991
Date of Dissolution:	February 1st 2013
Expiration date:	31 Dec 2013
UBI Number:	601 358 148

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Registered Agent Information

Name	Role	Address
JOSEPH A MCINTOSH	Registered Agent	719 2ND AVE STE 425, SEATTLE, WA, 98104, UNITED STATES

Key Officers & Management

Name	Role
DAVID LITTLE	Governing Person
ROBIN MITCHELL	Governing Person
DANIEL OSTRANDER	Governing Person
PHILIP WOLF	Governing Person

National Provider Identifier

NPI Number:

1902859598

Link:

View on NPI website

Authorized Person:

Name:

GARY WANDSCHNEIDER

Role:

PRESIDENT

Phone:

5099280300

Taxonomy:

Selected Taxonomy:

207Q00000X - Family Medicine Physician

Is Primary:

Yes

Contacts:

Phone:

+1 509-928-0300

Fax:

5099229241

Form 5500 Series

Employer Identification Number (EIN):

911539323

Plan Year:

2012

Number Of Participants:

46

Sponsor's telephone number:

5099280300

File:

Plan Administrator / Signatory:

DAVID LITTLE(Plan administrator)

Plan Year:

2011

Number Of Participants:

48

Sponsor's telephone number:

5099280300

File:

Plan Administrator / Signatory:

DAVID LITTLE(Plan administrator)

Plan Year:

2010

Number Of Participants:

45

Sponsor's telephone number:

5099280300

File:

Plan Administrator / Signatory:

DAVID LITTLE(Plan administrator)

Plan Year:

2009

Number Of Participants:

45

Sponsor's telephone number:

5099280300

File:

Plan Administrator / Signatory:

DAVID LITTLE(Plan administrator)

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