| Name: | PacificSource Administrators, Inc. |
| Jurisdiction: | Alaska |
| Legal type: | Business Corporation |
| Status: | Withdrawn |
| Date of registration: | 15 May 2006 (19 years ago) |
| Entity Number: | 101268 |
| Place of Formation: | OREGON |
| Mailing Address: | ATTN: GENERAL COUNSEL, PO BOX 7068, SPRINGFIELD, OR 97475 |
| Address: | ATTN: GENERAL COUNCEL, 110 INTERNATIONAL WAY, SPRINGFIELD, OR 97477 |
| Name | Role | Shares |
|---|---|---|
| C T Corporation System | Previous Registered Agent, Previous Registered Agent | - |
| Dan Stevens | Vice President | - |
| Dan Roth, M.D. | Vice President | - |
| David Abel MD | Previous Director, Previous Secretary, Previous Treasurer | - |
| Erick Doolen | Vice President | - |
| Kenneth P Provencher | President | - |
| Kenneth P Provencher | Previous Unknown Historic, Previous Director | - |
| Kristin Kernutt | Secretary | - |
| Pacific Hospital Association | Previous Shareholder | 100.00 |
| PacificSource Health Plans | Shareholder | 100.00 |
Date of last update: 11 Feb 2025
Sources: State of Alaska - Department of Commerce, Community, and Economic Development
