Organization
AESTHETIC SURGERY CENTER OF EUGENE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE V FAUSETT MD, PHD (OWNER/MEDICAL DIRECTOR)
(541) 434-0922
Entity
Organization
Contact information
Practice address
2550 WILLAKENZIE RD, EUGENE, OR 97401-7865
(541) 434-0922
(541) 434-4369
Mailing address
2550 WILLAKENZIE RD, EUGENE, OR 97401-7865
(541) 434-0922
(541) 434-4369
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
071545
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
298045
—
OR
Enumeration date
07/05/2005
Last updated
06/05/2025
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