Provider Demographics
NPI:1184680274
Name:STEINITZ, EDGAR S (MD)
Entity Type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:S
Last Name:STEINITZ
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 1:3315 S 23RD ST
Mailing Address - Street 2:STE 200
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1605
Mailing Address - Country:US
Mailing Address - Phone:253-272-9994
Mailing Address - Fax:253-572-0468
Practice Address - Street 1:3315 S 23RD ST
Practice Address - Street 2:STE 200
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1605
Practice Address - Country:US
Practice Address - Phone:253-272-9994
Practice Address - Fax:253-572-0468
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00017671174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1915602Medicaid
WA13689OtherLABOR & INDUSTRIEST
WAMD00017671OtherSTATE LICENSE
WAMD00017671OtherSTATE LICENSE
WAAS8866127OtherDEA
WAMD00017671OtherSTATE LICENSE