Provider Demographics
NPI:1073555124
Name:FINSTAD, TERRANCE A (MD)
Entity Type:Individual
Prefix:
First Name:TERRANCE
Middle Name:A
Last Name:FINSTAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 35145 LB 1154
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-5145
Mailing Address - Country:US
Mailing Address - Phone:541-387-6328
Mailing Address - Fax:541-387-6410
Practice Address - Street 1:811 13TH ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1204
Practice Address - Country:US
Practice Address - Phone:541-490-9474
Practice Address - Fax:541-387-6410
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000361132085R0202X
ORMD209802085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1109487OtherDSHS
ORAB1795Medicaid
OR134467Medicaid
ORR105852Medicare PIN
OR134467Medicaid