# FASA FAMILY WELLNESS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ankle & Foot Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861495640
- **Authorized official:** TERRENCE EUGENE HESS (OWNER)
- **Authorized official phone:** (360) 754-3338

## Contact information

- **Practice address:** 1114 BROADWAY ST, LONGVIEW, WA 98632-3842
- **Practice address phone:** (360) 577-3682
- **Practice address fax:** (360) 577-1871
- **Mailing address:** PO BOX 825159, PHILADELPHIA, PA 19182-5159
- **Mailing address phone:** (360) 577-3682
- **Mailing address fax:** (360) 577-1871

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | PO00000488 | WA | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 05/24/2005
- **Last updated:** 05/29/2025