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

Kiley Petencin

Individual provider Occupational Therapist · NPI 1639810823

Kiley Petencin is an Occupational Therapist in Idaho Falls, Idaho. Licensed in Idaho and Oregon. Registered with an NPI since 2022.

Licensed in
ID, OR
In the registry since
2022
Specialties on file
2

Practice location Address checks out

1460 Elk Creek Dr
Idaho Falls, ID 83404-8237
Phone: (208) 535-1286
Show map & directions

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

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence OT-1736 (ID)
Occupational Therapist Taxonomy 225X00000X · Licence 379227 (OR)

Record details

NPI number1639810823
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 5, 2022
Last updated in NPPESJuly 27, 2026
Certification dateJuly 27, 2026

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