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

Mrs. Katie Diana Waites, PA-C

Individual provider Physician Assistant · NPI 1306964994

Mrs. Katie Diana Waites, PA-C is a Physician Assistant in Boise, Idaho. Qualified in 2016, 10 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Idaho.

Years since qualifying
10
Licensed in
ID
In the registry since
2007
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

701 E Parkcenter Blvd
Boise, ID 83706-6528
Phone: (208) 381-4210
Fax: (208) 381-2045
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Additional practice locations (1)

  • 275 S Aspen St Stop 89, Aurora, CO 80011-9562 — (720) 277-9493

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-1501 (ID)

Record details

NPI number1306964994
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 26, 2007
Last updated in NPPESApril 4, 2025
Certification dateApril 4, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Boise