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
19 FONTANA LN STE 108, ROSEDALE, MD 21237-3097
(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
291U00000X
Clinical Medical Laboratory
Primary
5000076869
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
577253
—
MD
Enumeration date
09/26/2017
Last updated
08/31/2023
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