0001900839-22-000001.txt : 20220128 0001900839-22-000001.hdr.sgml : 20220128 20220127192001 ACCESSION NUMBER: 0001900839-22-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20220128 DATE AS OF CHANGE: 20220127 EFFECTIVENESS DATE: 20220128 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ASC Ballard LLC CENTRAL INDEX KEY: 0001900839 IRS NUMBER: 831636208 STATE OF INCORPORATION: WA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-431196 FILM NUMBER: 22564861 BUSINESS ADDRESS: STREET 1: 415 118TH AVENUE SE CITY: BELLEVUE STATE: WA ZIP: 98005 BUSINESS PHONE: (425) 861-9993 MAIL ADDRESS: STREET 1: 415 118TH AVENUE SE CITY: BELLEVUE STATE: WA ZIP: 98005 D 1 primary_doc.xml X0708 D LIVE 0001900839 ASC Ballard LLC 415 118TH AVENUE SE BELLEVUE WA WASHINGTON 98005 (425) 861-9993 WASHINGTON None None Limited Liability Company true 2018 Dwayne Clark 415 118th Avenue SE Bellevue WA WASHINGTON 98005 Executive Officer Promoter Jerry C. Meyer 415 118th Avenue SE Bellevue WA WASHINGTON 98005 Executive Officer Edward J. Poplawski 415 118th Avenue SE Bellevue WA WASHINGTON 98005 Executive Officer Adam Clark 415 118th Avenue SE Bellevue WA WASHINGTON 98005 Executive Officer Ashley Rea 415 118th Avenue SE Bellevue WA WASHINGTON 98005 Executive Officer Other Health Care Decline to Disclose 06b false 2022-01-14 false true false 0 19600000 19600000 0 false 84 0 0 0 false ASC Ballard LLC /s/ Ben Freeburg Ben Freeburg Authorized Signatory 2022-01-27