Organization
FASA FAMILY WELLNESS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRENCE EUGENE HESS (OWNER)
(360) 754-3338
Entity
Organization
Contact information
Practice address
1610 BISHOP RD SW, SUITE 101, TUMWATER, WA 98512-7303
(360) 754-3338
(360) 753-4861
Mailing address
PO BOX 825159, PHILADELPHIA, PA 19182-5159
(360) 338-0004
(360) 515-0744
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
602208923
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2047753
—
WA
01
—
50D2089344
CLIA WAIVER
WA
05
—
7122203
—
WA
Enumeration date
07/20/2006
Last updated
05/13/2025
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