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Individual

DR. THOMAS M FAURIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
2650 SUZANNE WAY 120, EUGENE, OR 97408-7619
(541) 345-2800
(541) 345-4419
Mailing address
2650 SUZANNE WAY 120, EUGENE, OR 97408-7619
(541) 345-2800
(541) 345-4419

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
722
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
810573161
CLINIC TAX ID
OR
01
844704003
REGENCE BCBSO PROV NO
OR
Enumeration date
05/07/2007
Last updated
02/07/2017
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