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CDA Wellness PLLC

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Company Details

Name: CDA Wellness PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 11 Dec 2022 (3 years ago)
Financial Date End: 31 Dec 2025
Date dissolved: 25 Mar 2025
Entity Number: 5026581
Place of Formation: IDAHO
File Number: 853334
ZIP code: 83858
County: Kootenai County
Mailing Address: CDA WELLNESS 6299 W ALLIANCE ST RATHDRUM, ID 83858-0139

Agent

Name Role Address
Katiuska Alexandra Vestman Agent 6299 W. ALLIANCE ST, RATHDRUM, ID 83858

Manager

Name Role Address Appointed On
Katiuska Alexandra Vestman Manager 4225 E. POLELINE AVE, POST FALLS, ID 83854 2023-12-03

National Provider Identifier

NPI Number:
1700616190
Certification Date:
2025-05-23

Authorized Person:

Name:
KATIUSKA ALEXANDRA VESTMAN
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QH0100X - Health Service Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2085999787

Filing

Filing Name Filing Number Filing date
Application for Reinstatement 0006177741 2025-03-31
Dissolution/Revocation - Administrative 0006170744 2025-03-25
Statement of Change of Business Mailing Address 0006147467 2025-03-07
Change of Registered Office/Agent/Both (by Entity) 0006147480 2025-03-07
Statement of Change of Business Mailing Address 0006097490 2025-02-05

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Date of last update: 10 Jul 2025

Sources: Idaho Secretary of State