FORM 1023-EZ for HUSKY HEALTH BRIDGE
| Field | Data |
|---|---|
| EIN | 81-4772619 |
| Case Number | EO-2017086-000192 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | HUSKY HEALTH BRIDGE |
| Organization’s Mailing Address | 1959 NE PACIFIC ST D322 BOX 356365 |
| City | SEATTLE |
| State | WA |
| ZIP | 98195-6365 |
| Accounting period End | 11 |
| Primary contact name | MARK VAN DUKER |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
JI HOON HWANG
PRESIDENT
1959 NE PACIFIC ST D322 BOX 356365
SEATTLE WA 98195-6365
Officer/Director/Trustee Two
MARK VAN DUKER
TREASURER
1959 NE PACIFIC ST D322 BOX 356365
SEATTLE WA 98195-6365
Officer/Director/Trustee Three
BRANDON WALKER
VICE PRESIDENT
1959 NE PACIFIC ST D322 BOX 356365
SEATTLE WA 98195-6365
Officer/Director/Trustee Four
JOHN BUI
SECRETARY
1959 NE PACIFIC ST D322 BOX 356365
SEATTLE WA 98195-6365
Officer/Director/Trustee Five
JESSICA LATIMER
DIRECTOR
1959 NE PACIFIC ST D322 BOX 356365
SEATTLE WA 98195-6365
| Organization’s website | HUSKYHEALTHBRIDGE.ORG |
|---|---|
| Organization’s email | HHBRIDGE@UW.EDU |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 11/30/2016 |
| Organization Incorporation State | WA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E30 - Health Treatment Facilities, Primarily Outpatient |
| Organization’s purpose | Charitable: Yes Religious: No Educational: No 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 | No |
| 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 | Yes |
| One Third Support Gifts | No |
| Benefit of College | No |
| Private Foundation 508(e) | No |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | |
| Signature Title | |
| Signature Date |
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