| Ideal Option, PLLC | |
|
1146 14th Ave Longview WA 98632-3017 | |
| (877) 522-1275 | |
| (509) 491-3031 |
| Full Name | Ideal Option, PLLC |
|---|---|
| Speciality | Clinic/center |
| Location | 1146 14th Ave, Longview, Washington |
| Authorized Official Name and Position | Brian Jefferson Dawson (CMO) |
| Authorized Official Contact | 5092221275 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ideal Option, PLLC 5615 Dunbarton Ave Pasco WA 99301-8216 Ph: (509) 570-9302 | Ideal Option, PLLC 1146 14th Ave Longview WA 98632-3017 Ph: (877) 522-1275 |
| NPI Number | 1164930905 |
|---|---|
| Provider Enumeration Date | 01/15/2018 |
| Last Update Date | 08/30/2023 |
| Certification Date | 08/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164930905 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Washington) | Primary |
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