OrganizationActive
Ideal Option, PLLC
NPI 1639690050 · Addiction Medicine (Family Medicine) Physician · Santa Fe, NM
Provider details
- NPI number
- 1639690050
- Entity type
- Organization
- Primary specialty
- Addiction Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Brian Dawson, Cmo(509) 222-1275
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
2019 Galisteo St Ste H1
Santa Fe, NM 87505-2106
Phone: (509) 222-1275
Approximate (ZIP-level) locationGet directions
Mailing address
8656 W Gage Blvd
Kennewick, WA 99336-7145
Registry dates
- Enumerated
- 2017-07-06
- Last updated
- 2023-08-30
- Certified
- 2023-08-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.