Ideal Option, Pllc | |
1140 Ne Burnside Rd Gresham OR 97030-5711 | |
(877) 522-1275 | |
(509) 491-3031 |
Full Name | Ideal Option, Pllc |
---|---|
Speciality | Clinic/center |
Location | 1140 Ne Burnside Rd, Gresham, Oregon |
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: (877) 522-1275 | Ideal Option, Pllc 1140 Ne Burnside Rd Gresham OR 97030-5711 Ph: (877) 522-1275 |
NPI Number | 1861989022 |
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Provider Enumeration Date | 04/13/2018 |
Last Update Date | 08/31/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1861989022 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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