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TRACI ANDERSON O.D., P.S.

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Company Details

Legal Name: TRACI ANDERSON O.D., P.S.
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL SERVICE CORPORATION
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: May 30th 2007
Date of Dissolution: October 18th 2016
Expiration date: 31 May 2016
UBI Number: 602 730 624
ZIP code: 99205
City: Spokane
County: SPOKANE
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 2301 W WELLESLEY, SPOKANE, WA, 99205, UNITED STATES

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Registered Agent Information

Name Role Address
TRACI ANDERSON Registered Agent 2116 S KATY CT, SPOKANE, WA, 99224-0000, UNITED STATES

Key Officers & Management

Name Role Address
TRACI ANDERSON Governing Person 2116 S KATY CT, SPOKANE, WA, 99224, UNITED STATES

National Provider Identifier

NPI Number:
1861654436

Authorized Person:

Name:
DR. TRACI ANDERSON
Role:
OPTOMETRIST
Phone:

Taxonomy:

Selected Taxonomy:
152W00000X - Optometrist
Is Primary:
Yes

Contacts:

Fax:
5093270494
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