| Ideal Option, Pllc | |
|
9735 Sw Shady Ln Ste 103 Tigard OR 97223-5481 | |
| (877) 522-1275 | |
| (509) 491-3031 |
| Full Name | Ideal Option, Pllc |
|---|---|
| Speciality | Clinic/center |
| Location | 9735 Sw Shady Ln Ste 103, Tigard, 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 8656 W Gage Blvd Ste 301b Kennewick WA 99336-7145 Ph: (877) 522-1275 | Ideal Option, Pllc 9735 Sw Shady Ln Ste 103 Tigard OR 97223-5481 Ph: (877) 522-1275 |
| NPI Number | 1780199679 |
|---|---|
| Provider Enumeration Date | 12/13/2017 |
| Last Update Date | 08/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780199679 | NPI | - | NPPES |
| 500698482 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Oregon) | Primary |
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