NPI 1225764541

Tanner Ryan Staley

Practitioner Physician Assistant Polson, MT

Practice location

Address: 104 Rufus Ln, Polson, MT 59860-8903
Phone: (406) 883-2555
Fax: (406) 883-2559

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X

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Registry record

NPI: 1225764541
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Jul 2022
Record last updated: 5 Nov 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.