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General NPI Number Information
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NPI Number | 1659617421
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Entity Type | Individual
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Provider Name | FAIILETASI V.S. EKEROMA M.A., LMFT
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Gender | Female
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Dates
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Enumeration Date | 12/21/2012
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 500 COLUMBIA ST NW STE 102
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City | OLYMPIA
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State | WA
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Zip | 98501-4447
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Country | US
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Telephone | 844-552-0141
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Fax |
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Provider Business Mailing Address
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Address Line | 700 SLEATER KINNEY RD SE SUITE B #185
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City | LACEY
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State | WA
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Zip | 98503-6746
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Country | US
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Telephone | 253-256-5149
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LF60788399
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License Number State | WA
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