IDEAL OPTION PLLC NPI 1457788275

NPI Information

NPI: 1457788275
Provider Name: IDEAL OPTION, PLLC
Classification: Preventive Medicine - 2083A0300X
Entity Type: Organization

Specialization: Addiction Medicine

CLIA Number: 50D2119795

Address:
5615 DUNBARTON AVE
PASCO, WA
ZIP 99301
Phone: (877) 522-1275
Get Directions

IDEAL OPTION, PLLC is an addiction medicine preventive medicine in Pasco, WA. The provider is a physician engaged in the subspecialty practice of Addiction Medicine who specializes in the prevention, evaluation, diagnosis, treatment, and recovery of persons with the disease of addiction. IDEAL OPTION, PLLC NPI is 1457788275. The provider is registered as an organization entity type.

The provider's business location address is:

5615 DUNBARTON AVE
PASCO, WA
ZIP 99301-216
Phone: (877) 522-1275
Fax: (509) 419-0253

The provider's authorized official is Brian Jefferson Dawson .
The authorized official title is Cmo and has the following contact phone number (509) 222-1275.

The CLIA number assigned to this NPI record is 50D2119795 - other - drug treatment with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/11/2013 and was last updated on 1/3/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251S00000X	Community/Behavioral Health				No
2	261Q00000X	Clinic/Center		MD00046152	WASHINGTON	No
3	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			No
4	2083A0300X	Preventive Medicine	Addiction Medicine			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2031254	MEDICAID	WASHINGTON
2	4243943	MEDICAID	MARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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