FORM 1023-EZ for PNW MIGRAINE CENTER

Field Data
EIN 85-2029674
Case Number EO-2021064-000620
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PNW MIGRAINE CENTER
Organization’s Mailing Address 424 NE FRANKLIN AVE
City BEND
State OR
ZIP 97701
Accounting period End 12
Primary contact name NATASHA RUEGSEGGER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEPHEN SMITHERMAN
PRESIDENT; SECRETARY
210 W EVERGREEN BLVD
VANCOUVER WA 98660

Officer/Director/Trustee Two

NATASHA RUEGSEGGER
VICE PRESIDENT; TREASURER
665 SE GLENGARRY
BEND OR 97702

Officer/Director/Trustee Three

MICHAEL LELL
CHAIRMAN OF THE BOARD
13237 SW 169TH AVE
BEAVERTON OR 97007

Officer/Director/Trustee Four

ERIC KIM
BOARD MEMBER
12535 SE 131ST CT
HAPPY VALLEY OR 97086

Officer/Director/Trustee Five

ANTON TIDRICK
BOARD MEMBER
665 SE GLENGARRY
BEND OR 97702

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/17/2020
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B99 - Education N.E.C.
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name STEPHEN SMITHERMAN
Signature Title PRESIDENT; SECRETARY
Signature Date 1/5/2021

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