Provider Demographics
NPI:1841874377
Name:TORGERSON, LEALAND ARTHUR (PA-C)
Entity type:Individual
Prefix:
First Name:LEALAND
Middle Name:ARTHUR
Last Name:TORGERSON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 190930
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83719-0930
Mailing Address - Country:US
Mailing Address - Phone:208-367-5170
Mailing Address - Fax:208-367-5180
Practice Address - Street 1:2090 WOODWINDS DR STE 200
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2522
Practice Address - Country:US
Practice Address - Phone:651-968-5201
Practice Address - Fax:651-968-5899
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2025-09-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN13643363A00000X
IDPA-2069363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant