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Organization

WESTERN STATE HOSPITAL

Active
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Organization

WESTERN STATE HOSPITAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LAUREL C. KELSO LICSW (PSYCHIATRIC SOCIALWORKER SUPERVISOR)
(253) 756-2966
Entity
Organization

Contact information

Practice address
9601 STEILACOOM BLVD SW, TACOMA, WA 98498-7212
(253) 756-3971
Mailing address
9601 STEILACOOM BLVD SW, TACOMA, WA 98498-7212
(253) 756-3971

Taxonomy

Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
PY60040431
WA

Other

Enumeration date
10/28/2010
Last updated
10/28/2010
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