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

Tyler Wagstaff

Individual provider Surgical Physician Assistant · NPI 1205266053

Tyler Wagstaff is a Surgical Physician Assistant in Kalispell, Montana. Licensed in Idaho and Montana. Registered with an NPI since 2013.

Licensed in
ID, MT
In the registry since
2013
Specialties on file
2

Practice location Address checks out

160 Heritage Way Ste 202
Kalispell, MT 59901-3127
Phone: (406) 752-8433
Fax: (406) 756-6768
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence MED-PAC-LIC-79860 (MT)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA1227 (ID)

Record details

NPI number1205266053
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 14, 2013
Last updated in NPPESMay 31, 2023
Certification dateMay 31, 2023
Mailing address350 Heritage Way Ste 2100, Kalispell, MT 59901-3167

Other providers in Kalispell