| Name: | Creekside Family Health Clinic, Incorporated |
| Jurisdiction: | Alaska |
| Legal type: | Business Corporation |
| Status: | Good Standing |
| Date of registration: | 02 Jan 2012 (13 years ago) |
| Entity Number: | 10002139 |
| ZIP code: | 99901 |
| County: | Ketchikan Gateway |
| Place of Formation: | ALASKA |
| Address: | 1225 TONGASS AVENUE, KETCHIKAN, AK 99901 |
Line of Business
62 Health Care and Social AssistanceNAICS
621498 ALL OTHER OUTPATIENT CARE CENTERS| Name | Role |
|---|---|
| Trevor Shaw | Director |
| Trevor Shaw | Shareholder |
| Shawna Strouth-Shaw | Shareholder |
| Shawna Strouth-Shaw | Director |
| Shawna Strouth-Shaw | President |
| Trevor Shaw | Secretary |
| Trevor Shaw | Treasurer |
| LISA SHAW | Assistant Secretary |
| LISA SHAW | Assistant Treasurer |
| Trevor Shaw | Vice President |
| Unique Entity ID | Expiration Date | Physical Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| YJYYMWZ5B9V7 | 2023-04-15 | 320 BAWDEN ST APT 313, KETCHIKAN, AK, 99901, 6544, USA | |||||||||||||||||||||||||||||||||||||||||
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| Congressional District | 00 |
| State/Country of Incorporation | AK, USA |
| Activation Date | 2022-03-18 |
| Initial Registration Date | 2021-04-13 |
| Entity Start Date | 2012-01-01 |
| Fiscal Year End Close Date | Dec 31 |
Service Classifications
| NAICS Codes | 621399, 621498, 621511 |
| Product and Service Codes | Q201, Q301, Q403, Q701 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | TREVOR A SHAW |
| Address | 320 BAWDEN ST, SUITE 312, KETCHIKAN, AK, 99901, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | TREVOR A SHAW |
| Address | 320 BAWDEN ST, SUITE 312, KETCHIKAN, AK, 99901, USA |
| Past Performance | - |
|---|
| Type | License Number | Status | Date of issue | Date of renewal | Expiration date | Description |
|---|---|---|---|---|---|---|
| Business License | 969121 | Active | 2012-02-07 | 2022-12-06 | 2024-12-31 | LOB: 62 - Health Care and Social Assistance, NAICS: 621498 - ALL OTHER OUTPATIENT CARE CENTERS |
| Telemedicine Business Registry | 159530 | Active | 2020-03-25 | - | - | - |
Date of last update: 10 Jan 2025
Sources: State of Alaska - Department of Commerce, Community, and Economic Development
