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INLAND NORTHWEST ANESTHESIA, PLLC

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Company Details

Name: INLAND NORTHWEST ANESTHESIA, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 09 Oct 2012 (13 years ago)
Financial Date End: 31 Oct 2025
Date dissolved: 27 Jun 2025
Entity Number: 362556
Place of Formation: IDAHO
File Number: 362556
ZIP code: 83814
County: Kootenai County
Principal Address: STE 300 850 W IRONWOOD DR COEUR D ALENE, ID 83814-4903

Member

Name Role Address Appointed On Resigned On
AnesthesiaVille Trust Member 850 W IRONWOOD DR, COEUR D ALENE, ID 83814 2021-03-24 No data
Go 2 Sleep Trust Member 1002 N SPOKANE STREET, POST FALLS, ID 83854 2020-11-02 2021-03-24

Agent

Name Role Address
Doran Thomas Agent 850 W IRONWOOD DR, STE 300, COEUR D ALENE, ID 83814-4903

National Provider Identifier

NPI Number:
1467797449
Certification Date:
2023-03-15

Authorized Person:

Name:
ANGIE RUTHERFORD
Role:
ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
367500000X - Certified Registered Nurse Anesthetist
Is Primary:
Yes

Contacts:

Fax:
2084577079

Filing

Filing Name Filing Number Filing date
Application for Reinstatement 0006332430 2025-06-30
Dissolution/Revocation - Administrative 0006330728 2025-06-27
Notice of Determination 0006202926 2025-04-10
Annual Report 0005897546 2024-09-11
Annual Report 0005398684 2023-09-11

Paycheck Protection Program

Jobs Reported:
11
Initial Approval Amount:
$110,273.27
Date Approved:
2020-04-07
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$110,273.27
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$111,061.8
Servicing Lender:
Glacier Bank
Use of Proceeds:
Payroll: $110,273.27

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Date of last update: 20 Jul 2025

Sources: Idaho Secretary of State