FASA FAMILY WELLNESS PLLC NPI 1255351714

NPI Information

FASA FAMILY WELLNESS, PLLC is an ambulatory surgical clinic center in Tumwater, WA. FASA FAMILY WELLNESS, PLLC NPI is 1255351714. The provider is registered as an organization entity type.

The provider's business location address is:

1610 BISHOP RD SW
SUITE 101
TUMWATER, WA
ZIP 98512-303
Phone: (360) 754-3338
Fax: (360) 753-4861

The provider's authorized official is Dana Eberhard .
The authorized official title is Credentialing Specialist and has the following contact phone number (360) 706-2767.

The CLIA number assigned to this NPI record is 50D2089344 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/20/2006 and was last updated on 5/20/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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