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

Travis Wahl

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1528653045

Travis Wahl is a Physician Assistant in Boise, Idaho. Qualified in 2021, 5 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Arizona and Idaho.

Years since qualifying
5
Licensed in
AZ, ID
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

222 N 2nd St Ste 215
Boise, ID 83702-6130
Phone: (208) 381-5500
Fax: (208) 381-2555
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 435 N 5th St, Phoenix, AZ 85004-2157 — (602) 827-2450
  • 6140 W Curtisian Ave Ste 300, Boise, ID 83704-0107 — (208) 302-0000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-2138 (ID)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (AZ)

Record details

NPI number1528653045
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 5, 2021
Last updated in NPPESOctober 17, 2024
Certification dateOctober 17, 2024
Mailing address190 E Bannock St, Boise, ID 83712-6241

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 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 locations6 on file with Medicare

Other providers in Boise