Provider Demographics
NPI:1588451595
Name:PERMANENT HAIR REMOVAL LLC
Entity type:Organization
Organization Name:PERMANENT HAIR REMOVAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-583-2430
Mailing Address - Street 1:PO BOX 83022
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97283-0022
Mailing Address - Country:US
Mailing Address - Phone:503-583-2430
Mailing Address - Fax:
Practice Address - Street 1:189 LIBERTY ST NE STE 203C
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4546
Practice Address - Country:US
Practice Address - Phone:503-583-2430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-22
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty