FORM 1023-EZ for NORTH CENTRAL WASHINGTON INTEGRATEDHEALTH NETWORK

Field Data
EIN 46-4018137
Case Number EO-2015364-000177
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NORTH CENTRAL WASHINGTON INTEGRATEDHEALTH NETWORK
Organization’s Mailing Address PO BOX 116
City MALAGA
State WA
ZIP 98828
Accounting period End 12
Primary contact name KARI LYONS PRICE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KARI LYONS PRICE
PRESIDENT
PO BOX 116
MALAGA WA 98828

Officer/Director/Trustee Two

JOHN NEFF
VICE-PRESIDENT
10470 TITUS RD
LEAVENWORTH WA 98826-9509

Officer/Director/Trustee Three

ADRIAN NOWLAND
SECRETARY
PO BOX 1415
CHELAN WA 98816

Organization’s website WWW.NCWIHN.COM
Organization’s email KARI@NCWIHN.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/4/2013
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
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 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 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
Signature Title
Signature Date

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