NPIMap

Organization Active NPI

Fasa Family Wellness, PLLC

  • Ambulatory Surgical Clinic/Center
  • Tumwater, WA
National Provider Identifier
1255351714
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
602208923 Issued in WA
Legal business name
FASA FAMILY WELLNESS, PLLC
Practice address
1610 Bishop Rd SW
Suite 101
Tumwater, WA 98512-7303
Phone
(360) 754-3338
Fax
(360) 753-4861
NPI assigned
Jul 20, 2006
Last updated
May 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Terrence Eugene HessNPI 1194748913
Title
Owner
Phone
(360) 754-3338

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 602208923 WA Primary

Addresses

Primary practice location

1610 Bishop Rd SW
Suite 101
Tumwater, WA 98512-7303

Mailing address

PO Box 825159
Philadelphia, PA 19182-5159
Phone (360) 338-0004

Other identifiers 3

IdentifierTypeStateIssuer
7122203MedicaidWA
50D2089344OtherWACLIA WAIVER
2047753MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150508000676 WA Part B Supplier - Ambulatory Surgical Center 7618290297 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Tumwater, WA

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Foot and Ankle Surgery Associates Inc PSCCN 50C0001219
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Fasa Family Wellness PLLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1610 Bishop Rd SW
Ste 101
Tumwater, WA 98512
Phone (360) 754-3338

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747094400000",
    "number": "1255351714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 825159",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191825159",
            "telephone_number": "360-338-0004",
            "fax_number": "360-515-0744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 BISHOP RD SW",
            "address_2": "SUITE 101",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985127303",
            "telephone_number": "360-754-3338",
            "fax_number": "360-753-4861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FASA FAMILY WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A",
        "authorized_official_last_name": "HESS",
        "authorized_official_first_name": "TERRENCE",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-754-3338"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": "602208923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7122203",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA WAIVER",
            "identifier": "50D2089344",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2047753",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tumwater, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.