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NPI Code Detail

MEDICARE: MS. FAIILETASI V.S. EKEROMA M.A., LMFT

MEDICARE: MS. FAIILETASI V.S. EKEROMA M.A., LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistLF60788399WA

General Provider Information

NPI Number : 1659617421
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. FAIILETASI V.S. EKEROMA M.A., LMFT
Provider Business Mailing Address
First Line : 700 SLEATER KINNEY RD SE
Second Line : SUITE B #185
City : LACEY
State : WA
Zip : 98503-6746
Country : US
Telephone Number : 253-256-5149
Fax Number :
Provider Business Practice Location Address
First Line : 500 COLUMBIA ST NW STE 102
Second Line :
City : OLYMPIA
State : WA
Zip : 98501-4447
Country : US
Telephone Number : 844-552-0141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2012
Last Update Date : 07/30/2025

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