Healthcare Provider Details

I. General information

NPI: 1760270714
Provider Name (Legal Business Name): AKESO PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 NE KAMIAKEN ST
PULLMAN WA
99163-2611
US

IV. Provider business mailing address

167 NE KAMIAKEN ST
PULLMAN WA
99163-2611
US

V. Phone/Fax

Practice location:
  • Phone: 509-595-5579
  • Fax:
Mailing address:
  • Phone: 509-595-5579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY DYLAN KELLER
Title or Position: PMHNP
Credential: NP
Phone: 509-595-5579