# PACIFIC PLASTIC SURGERY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659331007
- **Authorized official:** MS. LOIS M FONDREN MBA (MANAGER)
- **Authorized official phone:** (541) 683-0878

## Contact information

- **Practice address:** 743 COUNTRY CLUB RD, EUGENE, OR 97401-6019
- **Practice address phone:** (541) 683-0878
- **Practice address fax:** (541) 683-5206
- **Mailing address:** 743 COUNTRY CLUB RD, EUGENE, OR 97401-6019
- **Mailing address phone:** (541) 683-0878
- **Mailing address fax:** (541) 683-5206

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | MD13772 | OR | Yes |

## Other

- **Enumeration date:** 03/27/2006
- **Last updated:** 10/19/2009