Organization
IDEAL OPTION, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN JEFFERSON DAWSON MD (CMO)
(509) 222-1275
Entity
Organization
Contact information
Practice address
401 W MAIN ST STE 405, WALLA WALLA, WA 99362-2837
(509) 222-1275
(509) 491-3031
Mailing address
8656 W GAGE BLVD STE 301B, KENNEWICK, WA 99336-7145
(509) 222-1275
(509) 491-3031
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2031254
—
WA
Enumeration date
10/16/2017
Last updated
08/30/2023
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