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TRICITY INJURY CLINIC PLLC

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Company Details

Legal Name: TRICITY INJURY CLINIC PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: March 1st 2024
Expiration date: 31 Mar 2026
UBI Number: 605 441 561
ZIP code: 99338
City: Kennewick
County: BENTON
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 4309 W 27TH PL STE B202, KENNEWICK, WA, 99338-2914, UNITED STATES
Principal Office Mailing Address: Google Maps Logo 3911 W 27TH AVE STE 101 PMB 14, KENNEWICK, WA, 99337-2483, UNITED STATES

Contact Details

E-Mail: MCHAN@TRICITYINJURY.COM

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
MICHAEL CHAN Registered Agent 5455 PLEASURE POINT LN SE, BELLEVUE, WA, 98006-2637, UNITED STATES

Key Officers & Management

Name Role Address
MICHAEL CHAN Executor 5455 PLEASURE POINT LN SE, BELLEVUE, WA, 98006-2637, UNITED STATES
MICHAEL CHAN Governing Person -
TRAVIS VAUGHN Governing Person -
JOHN GRONER Governing Person -

National Provider Identifier

NPI Number:
1396504023
Certification Date:
2024-03-15

Authorized Person:

Name:
JOHN B GRONER
Role:
MEDICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
2081P2900X - Pain Medicine (Physical Medicine & Rehabilitation) Physician
Is Primary:
Yes

Contacts:

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