MEDICARE: KYLE CALDWELL MCCARTT PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA70090616	WA

General Provider Information

NPI Number	:	1962220327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE CALDWELL MCCARTT PA

Provider Business Mailing Address
First Line	:	808 N 5TH AVE
Second Line	:
City	:	SEQUIM
State	:	WA
Zip	:	98382-3045
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	808 N 5TH AVE
Second Line	:
City	:	SEQUIM
State	:	WA
Zip	:	98382-3045
Country	:	US
Telephone Number	:	360-683-5900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2024
Last Update Date	:	03/05/2026

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