# FASA FAMILY WELLNESS, PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1255351714
- **Authorized official:** TERRENCE EUGENE HESS (OWNER)
- **Authorized official phone:** (360) 754-3338

## Contact information

- **Practice address:** 1610 BISHOP RD SW, SUITE 101, TUMWATER, WA 98512-7303
- **Practice address phone:** (360) 754-3338
- **Practice address fax:** (360) 753-4861
- **Mailing address:** PO BOX 825159, PHILADELPHIA, PA 19182-5159
- **Mailing address phone:** (360) 338-0004
- **Mailing address fax:** (360) 515-0744

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 602208923 | WA | Yes |

## Other

- **Enumeration date:** 07/20/2006
- **Last updated:** 05/13/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2047753 | — | WA |
| 01 | — | 50D2089344 | CLIA WAIVER | WA |
| 05 | — | 7122203 | — | WA |