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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