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

Travis John Poulson, LAT, ATC, CSCS

Individual provider Sports Medicine (Physical Medicine & Rehabilitation) Physician · NPI 1609453380

Travis John Poulson, LAT, ATC, CSCS is a Sports Medicine (Physical Medicine & Rehabilitation) Physician in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2021.

Licensed in
ID
In the registry since
2021
What do these letters mean?
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

1910 University Dr
Boise, ID 83725-0002
Phone: (262) 949-4026
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Physical Medicine & Rehabilitation) Physician (primary) Taxonomy 2081S0010X · Licence AT-713 (ID)

Record details

NPI number1609453380
Entity typeIndividual (Type 1)
GenderMale
Credentials LAT , ATC , CSCS
Sole proprietorNo
NPI enumeratedMarch 27, 2021
Last updated in NPPESMarch 27, 2021
Certification dateMarch 27, 2021

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