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Individual

EDWIN M TINGSTAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
825 SE BISHOP BLVD STE 120, PULLMAN, WA 99163-5517
(509) 332-2828
Mailing address
2500 W A ST, SUITE 201, MOSCOW, ID 83843-6000

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
37180
WA
207X00000X
Orthopaedic Surgery Physician
M8045
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1003546
WA
05
1110857
WA
01
135969
WA DEPT OF LABOR
WA
05
805780700
ID
Enumeration date
08/09/2006
Last updated
08/04/2025
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