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TRI-CITIES INFUSION AND WELLNESS CLINIC, PLLC

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Company Details

Legal Name: TRI-CITIES INFUSION AND WELLNESS CLINIC, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: February 27th 2019
Expiration date: 28 Feb 2026
UBI Number: 604 388 121
ZIP code: 99336
City: Kennewick
County: BENTON
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 5373 W CANAL DR STE 120, KENNEWICK, WA, 99336-1332, UNITED STATES

Contact Details

E-Mail: BEN.CLARK@TRICITIESWELLNESS.COM
Phone Number: +1 509-581-1005

Nature of Business

Other Services

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Registered Agent Information

Name Role Address
BENJAMIN CLARK Registered Agent 2938 SUNSHINE RIDGE RD, RICHLAND, WA, 99352-9300, UNITED STATES

Key Officers & Management

Name Role Address
TYLER THORNOCK Executor 15205 S MOUNTAIN RIDGE CT, KENNEWICK, WA, 99338-8325, UNITED STATES
BENJAMIN CLARK Executor 2938 SUNSHINE RIDGE RD, RICHLAND, WA, 99352-9300, UNITED STATES
BENJAMIN CLARK Governing Person -
TYLER THORNOCK Governing Person -

National Provider Identifier

NPI Number:
1417415530

Authorized Person:

Name:
TYLER THORNOCK
Role:
GOVENOR
Phone:

Taxonomy:

Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
141741553
Plan Year:
2023
Number Of Participants:
11
Plan Name:
401(K)
Sponsor's telephone number:
Plan Administrator / Signatory:
FIDUCIARY ASSISTANCE(Plan administrator)
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