Individual ProviderLaurel C KelsoSocial WorkerBehavioral Health & Social Service ProvidersPractice Address7191 Wagner Way, Suite 301, Gig Harbor, WA 98335-0115(253) 514-8076(253) 588-7911PECOS EnrollmentBased on the most recent information from CMS, provider Laurel C Kelso does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1245478064Provider TypeIndividualFull NameKelso, Laurel CCredentialLCSWGenderFemaleSole ProprietorNoEnumeration Date2/2/2009Last Updated2/20/2013Contact InformationPractice LocationPractice Address7191 Wagner Way, Suite 301, Gig Harbor, WA 98335-0115Phone(253) 514-8076Fax(253) 514-8078Mailing LocationMailing AddressPO Box 97115, Lakewood, WA 98497-0115Phone(253) 588-7911FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseLW00007524WashingtonProvider IdentifiersIDDescriptionIssuerIDLW00007524DescriptionOtherIssuerPROFESSIONAL LICENSEWashington