Individual ProviderTonya Michelle KellyCounselorBehavioral Health & Social Service ProvidersPractice Address711 State Ave NE, Olympia, WA 98506-3984(360) 943-0780PECOS EnrollmentBased on the most recent information from CMS, provider Tonya Michelle Kelly 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 2 days ago.Profile DetailsProvider ID1093365694Provider TypeIndividualFull NameKelly, Tonya MichelleGenderFemaleSole ProprietorNoEnumeration Date9/16/2019Last Updated9/16/2019Contact InformationPractice LocationPractice Address711 State Ave NE, Olympia, WA 98506-3984Phone(360) 943-0780FaxUnlisted FaxMailing LocationMailing Address711 State Ave NE, Olympia, WA 98506-3984PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101Y00000XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseCG61005534Washington