Individual
DIANE SYLVIA WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
TATTOO ARTIST
Contact information
Practice address
201 NE PARK PLAZA DR STE 246, VANCOUVER, WA 98684-5874
(360) 936-7380
Mailing address
11943 NE 109TH WAY, VANCOUVER, WA 98662-3423
(360) 936-7380
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
2417
WA
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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