Organization · Type 2 NPI
Fasa Family Wellness, PLLC
Foot & Ankle Surgery Podiatrist · Longview, WA
NPI number
1861495640
Active
Practice location
1114 Broadway St
Longview, WA 98632-3842
Fax (360) 577-1871
Mailing address
PO Box 825159
Philadelphia, PA 19182-5159
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foot & Ankle Surgery Podiatrist Primary | 213ES0103X | PO00000488 (WA) |
| Durable Medical Equipment & Medical Supplies | 332B00000X | None listed |
Foot & Ankle Surgery Podiatrist: Definition to come...
About NPI 1861495640
Fasa Family Wellness, PLLC's National Provider Identifier is 1861495640, issued on May 24, 2005. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Longview, WA. The record was last updated on May 29, 2025.