Well, I have an update, but not much good news.
After working on this issue for months, I finally decided to take it to a mechanic in the area who has a lot of experience working on older cards. Long story short - he checked everything he could think of and spent many hours investigating, but was only able to drop the high idle by adding a new IAC valve (note that I tried two different brand new ones before taking it to him). This did seem to drop the idle moderately (1500-2000 down to 1200, so still high), but the "surging" or "spiking" idle issue while the car is in neutral still exists. The mechanic confirmed that all sensors seem to be functioning properly.
Please see this Youtube video to see the idle spiking:
The issue occurs when the car is in neutral, like when I am coasting to a stop light. It doesn't matter whether or not I have the clutch depressed. The engine basically revs from about 800 rpm up to 1200 rpm then back down to 800, and repeats about once per second until I come to a stop.
To make things more complicated: it is important to note that the tachometer does have issues and isn't always accurate, which was confirmed by the mechanic. I do not think this negates the surging issue, since I can literally hear the engine and transmission revving when it happens (it is hard to hear in the video). But this does make things more difficult, since we cannot be super confident in the tachometer readings.
A couple of thoughts since taking it in:
One of the mechanics thought that the truck may have had the transmission swapped from automatic to manual in the past, although the stock sticker inside the driver's door does seem to indicate that it was originally manual (see pic).
I do know that the steering column was replaced before I bought it. This is especially evident because I have to use a custom ignition push button on the left side of the steering wheel. This may be why the mechanic thought it used to be automatic.
Any idea why someone would have swapped out the steering column in the past? Could this be the cause of the issue?
Also, is it possible that the issue is related to the transmission? The "surging" sound that I hear seems to be coming in large part from the transmission tunnel. I am wondering if the issue could be some feedback problem between the engine and transmission.