Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tanner Ryan Staley

Individual provider Physician Assistant · NPI 1225764541

Tanner Ryan Staley is a Physician Assistant in Polson, Montana. Qualified in 2022, 4 years ago. Practices with St Lukes Community Hospital, a 61-clinician group and accepts Medicare assignment. Licensed in Montana.

Years since qualifying
4
Licensed in
MT
In the registry since
2022

Practice location Address checks out

104 Rufus Ln
Polson, MT 59860-8903
Phone: (406) 883-2555
Fax: (406) 883-2559
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (MT)

Record details

NPI number1225764541
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 28, 2022
Last updated in NPPESNovember 5, 2024
Certification dateNovember 5, 2024
Mailing address104 Rufus Ln, Polson, MT 59860-8903

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice St Lukes Community Hospital — 61 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Polson