STANLEY D. BORISH, M.D., INC. P.S.

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Company Details

Legal Name:	STANLEY D. BORISH, M.D., INC. P.S.
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL SERVICE CORPORATION
Category:	DOMESTIC ENTITY
Status:	Administratively Dissolved
Formation/ Registration Date:	February 20th 1980
Date of Dissolution:	July 3rd 2020
Expiration date:	28 Feb 2020
UBI Number:	600 353 464
ZIP code:	98199
City:	Seattle
County:	KING
Home State:	WASHINGTON
Principal Office Street Address:	2217 W VIEWMONT WAY W, SEATTLE, WA, 98199-3951, UNITED STATES

Contact Details

E-Mail:

SDB0889@COMCAST.NET

Nature of Business

Professional, Scientific & Technical Services

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Registered Agent Information

Name	Role	Address
STANLEY D BORISH MD INC PS	Registered Agent	2217 W VIEWMONT WAY W, SEATTLE, WA, 98199-3951, UNITED STATES

Key Officers & Management

Name	Role	Address
STANLEY BORISH	Governing Person	19526 64TH AVE WEST, LYNNWOOD, WA, 98036, UNITED STATES
JUDITH BORISH	Governing Person	19526 64TH AVE WEST, 19526 64TH AVE WEST, LYNNWOOD, WA, 98036, UNITED STATES

National Provider Identifier

NPI Number:

1740502731

Link:

View on NPI website

Authorized Person:

Name:

STANLEY D BORISH

Role:

PHYSICIAN, CEO

Phone:

4257741685

Taxonomy:

Selected Taxonomy:

261QP2300X - Primary Care Clinic/Center

Is Primary:

Yes

Contacts:

Phone:

+1 425-774-1685

Fax:

4256700713

Form 5500 Series

Employer Identification Number (EIN):

911093023

Plan Year:

2014

Number Of Participants:

2

Sponsor's telephone number:

4258276100

File:

Plan Administrator / Signatory:

PHILIP MAXEINER(Plan administrator)

Plan Year:

2013

Number Of Participants:

2

Sponsor's telephone number:

4258276100

File:

Plan Administrator / Signatory:

PHILIP MAXEINER(Plan administrator)

Plan Year:

2012

Number Of Participants:

2

Sponsor's telephone number:

4258276100

File:

Plan Administrator / Signatory:

PHILIP MAXEINER(Plan administrator)

Plan Year:

2011

Number Of Participants:

2

Sponsor's telephone number:

4258276100

File:

Plan Administrator / Signatory:

PHILIP MAXEINER(Plan administrator)

Plan Year:

2010

Number Of Participants:

3

Sponsor's telephone number:

4258276100

File:

Plan Administrator / Signatory:

PHILIP MAXEINER(Plan administrator)

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