| Doctor Name: | MR. THOMAS L. FASNACHT |
| NPI Number: | 1821482340 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 17073 Hamlin Rd Ne Lake Forest Park, WA - 981555529 |
| Business Phone Number: | 2067137684 |
| Business Fax Number: | |
| Mailing Address: | 17073 Hamlin Rd Ne, LAKE FOREST PARK |
| State: | WA |
| Postal Code: | 981555529 |
| Phone Number: | 2067137684 |
| Fax Number: | |
| NPI Enumeration Date: | 03/23/2015 |
| NPI Last Update Date: | 03/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471V0105X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Vascular Sonography |
| Taxonomy Definition: | |