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GEM STATE ENDOSCOPY, PLLC

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Company Details

Name: GEM STATE ENDOSCOPY, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 19 Feb 2016 (10 years ago)
Financial Date End: 28 Feb 2026
Entity Number: 493678
Place of Formation: IDAHO
File Number: 493678
ZIP code: 83501
County: Nez Perce County
Principal Address: 3709 14TH STREET LEWISTON, ID 83501
Mailing Address: 3709 14TH ST LEWISTON, ID 83501-5709

Agent

Name Role Address
CARL DETWILER, MD Agent 36108 MILLER ROAD, LEWISTON, ID 83501

Member

Name Role Address Appointed On
Carl Dettwiler Member 36108 MILLER ROAD, LEWISTON, ID 83501 2021-02-09

U.S. Small Business Administration Profile

Phone Number:
E-mail Address:
Contact Person:
KATIE BLEVINS
Ownership and Self-Certifications:
Self-Certified Small Disadvantaged Business
User ID:
P3143721
Trade Name:
GEM STATE ENDOSCOPY

Unique Entity ID

Unique Entity ID:
RPYNWL8JEJ15
CAGE Code:
9KYN4
UEI Expiration Date:
2026-01-27

Business Information

Doing Business As:
GEM STATE ENDOSCOPY
Division Name:
GEM STATE ENDOSCOPY
Activation Date:
2025-01-28
Initial Registration Date:
2023-04-25

Commercial and government entity program

CAGE number:
9KYN4
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2025-01-28
CAGE Expiration:
2030-01-28
SAM Expiration:
2026-01-27

Contact Information

POC:
KATIE BLEVINS
Corporate URL:
www.clearwatergastro.net

National Provider Identifier

NPI Number:
1821459496

Authorized Person:

Name:
KATIE BLEVINS
Role:
ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2087433369

Filing

Filing Name Filing Number Filing date
Annual Report 0006043714 2025-01-03
Annual Report 0005535717 2024-01-03
Annual Report 0005052456 2023-01-04
Annual Report 0004585237 2022-01-31
Annual Report 0004169413 2021-02-09

USAspending Awards / Financial Assistance

Date:
2021-01-23
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
131757.00
Total Face Value Of Loan:
131757.00
Date:
2020-04-16
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
114900.00
Total Face Value Of Loan:
114900.00

Paycheck Protection Program

Jobs Reported:
9
Initial Approval Amount:
$131,757
Date Approved:
2021-01-21
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$131,757
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$132,265.98
Servicing Lender:
Zions Bank, A Division of
Use of Proceeds:
Payroll: $131,754
Utilities: $1
Jobs Reported:
9
Initial Approval Amount:
$114,900
Date Approved:
2020-04-16
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$114,900
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$115,919.93
Servicing Lender:
Zions Bank, A Division of
Use of Proceeds:
Payroll: $114,900

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Date of last update: 10 Aug 2025

Sources: Idaho Secretary of State