IDEAL OPTION PLLC NPI 1598276628

NPI Information

  • NPI: 1598276628
  • Provider Name: IDEAL OPTION, PLLC
  • Classification: Family Medicine - 207QA0401X
  • Specialization: Addiction Medicine
  • Entity Type: Organization
  • CLIA Number: 50D2043414
  • Address: 5431 E MAYFLOWER LN STE 4
    WASILLA, AK
    ZIP 99654
  • Phone: (509) 222-1275

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NPI Details

IDEAL OPTION, PLLC is an addiction medicine family medicine in Wasilla, AK. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. IDEAL OPTION, PLLC NPI is 1598276628. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5431 E MAYFLOWER LN STE 4
WASILLA, AK
ZIP 99654-891
Phone: (509) 222-1275
Fax: (509) 491-3031

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 50D2043414 - independent with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 10/16/2017 and was last updated on 8/30/2023.

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
1207QA0401XFamily MedicineAddiction MedicineYes

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
11671921MEDICAIDALASKA

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: 3/30/2025

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