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Northwest Accident and Injury Clinic LLC

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Company Details

Name: Northwest Accident and Injury Clinic LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 19 Oct 2020 (5 years ago)
Financial Date End: 31 Oct 2025
Entity Number: 4036996
Place of Formation: IDAHO
File Number: 730294
ZIP code: 83642
County: Ada County
Principal Address: 2090 S EAGLE RD MERIDIAN, ID 83642
Mailing Address: STE C 512 N YOUNG ST KENNEWICK, WA 99336-7839

Agent

Name Role Address
REDLINE REGISTERED AGENTS LLC Agent 1112 W MAIN ST, STE 101, BOISE, ID 83702

Member

Name Role Address Appointed On
Benjamin Ramos Member 2090 S. EAGLE ROAD, MERIDIAN, ID 83642 2024-09-03
Andrew Ryan Member 2090 S EAGLE RD, MERIDIAN, ID 83642 2023-09-07
Aaron Jorgensen Member 2090 S EAGLE RD, MERIDIAN, ID 83642 2021-09-21
Benjamin Gold Member 2090 S EAGLE RD, MERIDIAN, ID 83642 2023-09-07

National Provider Identifier

NPI Number:
1366031700
Certification Date:
2021-01-11

Authorized Person:

Name:
LORI ANN HALEY
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
111N00000X - Chiropractor
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0005877948 2024-09-03
Annual Report 0005388565 2023-09-07
Annual Report 0004889764 2022-09-08
Annual Report 0004424702 2021-09-21
Initial Filing 0004036996 2020-10-19

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Date of last update: 15 Jun 2025

Sources: Idaho Secretary of State