Organization
COUGARSTYLE LLC
Active
Other names
Columbia Gorge LipoMelt
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANE LYNN WANOUS LPN (LPN/OWNER/OPERATOR)
(541) 705-5860
Entity
Organization
Contact information
Practice address
802 W 6TH ST # 100, THE DALLES, OR 97058-1102
(541) 705-5860
Mailing address
802 W 6TH ST # 100, THE DALLES, OR 97058-1102
(541) 705-5860
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
—
—
Other
Enumeration date
08/08/2023
Last updated
08/08/2023
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