Healthcare Provider Details

I. General information

NPI: 1780374983
Provider Name (Legal Business Name): KALEN MARIE GUNTER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2023
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 YELLOWSTONE AVENUE
WEST YELLOWSTONE MT
59758
US

IV. Provider business mailing address

PO BOX 208
ALDER MT
59710-0208
US

V. Phone/Fax

Practice location:
  • Phone: 406-646-9441
  • Fax:
Mailing address:
  • Phone: 435-820-2007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMED-PAC-LIC-136407
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMED-PAC-LIC-136407
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA-2747
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: