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Palouse Specialty Physicians, P.S. Corp

Company Details

Name: Palouse Specialty Physicians, P.S. Corp
Jurisdiction: Idaho
Legal type: Foreign Nonprofit Corporation
Status: Active-Good Standing
Date of registration: 02 Dec 2024 (6 months ago)
Financial Date End: 31 Dec 2025
Entity Number: 5998259
Place of Formation: WASHINGTON
File Number: 966218
ZIP code: 83843
County: Latah County
Principal Address: STE 501 825 SE BISHOP BLVD PULLMAN, WA 99163
Mailing Address: STE 8 111 N WASHINGTON ST MOSCOW, ID 83843-2802

Agent

Name Role Address
C T CORPORATION SYSTEM Agent 1555 W SHORELINE DR, STE 100, BOISE, ID 83702

National Provider Identifier

NPI Number:
1770298333
Certification Date:
2024-11-19

Authorized Person:

Name:
SACHA L SMITH
Role:
DIRECTOR OF OPERATIONS
Phone:

Taxonomy:

Selected Taxonomy:
207RH0003X - Hematology & Oncology Physician
Is Primary:
Yes

Contacts:

Fax:
5092529339

Filing

Filing Name Filing Number Filing date
Initial Filing 0005998259 2024-12-02

Date of last update: 23 May 2025

Sources: Idaho Secretary of State