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 3 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