NPIMap

Organization Active NPI

Fasa Family Wellness PLLC

  • Family Medicine Physician
  • Centralia, WA
National Provider Identifier
1679979769
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FASA FAMILY WELLNESS PLLC
Practice address
1220 W 1St St
Suite B
Centralia, WA 98531-3018
Phone
(360) 736-4151
NPI assigned
Nov 17, 2014
Last updated
May 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 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 with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X
Durable Medical Equipment & Medical Supplies 332B00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X

Addresses

Primary practice location

1220 W 1St St
Suite B
Centralia, WA 98531-3018

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150107000888 WA Part B Supplier - Clinic/Group Practice 7618290297 Receives reassigned benefits from 23 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ellensburg, WA; Yakima, WA; University Place, WA; Tumwater, WA; Longview, WA; Lacey, WA; Centralia, WA; Olympia, WA
O20150427002532 WA DME Supplier - Physician - Podiatry 7618290297 Practice locations: Centralia, WA

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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.

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1416182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748476800000",
    "number": "1679979769",
    "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": "1220 W 1ST ST",
            "address_2": "SUITE B",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985313018",
            "telephone_number": "360-736-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FASA FAMILY WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-17",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "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": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.