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WARREN PHYSICIAN SERVICES, PLLC

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Company Details

Legal Name: WARREN PHYSICIAN SERVICES, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: December 11th 2009
Date of Dissolution: April 1st 2014
Expiration date: 31 Dec 2013
UBI Number: 602 975 562
ZIP code: 98503
City: Lacey
County: THURSTON
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 5420 22ND AVE SE, LACEY, WA, 98503, UNITED STATES

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Key Officers & Management

Name Role Address
CRAIG WARREN Governing Person -
CRAIG WARREN EXECUTOR 5420 22ND AVE SE, LACEY, WA, 98503, UNITED STATES

National Provider Identifier

NPI Number:
1710219522

Authorized Person:

Name:
DR. CRAIG M WARREN
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

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