P Praxis·MD
● Active Type 1 · Individual

MR. Kristopher Dwayne Wallin, COTA/L

Occupational Therapy Assistant·Boise, ID· NPI 1205215274 · Enumerated 2015 · 10 years on NPI
Wallin is 1 of 41 occupational therapy assistant providers in Boise and 1 of 160 in Idaho.
NPI age
10 years
Enumerated 2015-05-24
Primary specialty
Occupational Therapy Assistant
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2015-05-24
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 160 active occupational therapy assistant providers in Idaho.

NPI age
10 years
≈ at median (9 yr)
State licenses
1 state
1% of peers hold multiple states
Subspecialties
0
3% of peers hold subspecialties

NPI lifetime · 2015 → 2026

2015-05Enumerated in NPPES
2015 2026

Where they practice

Practice location
8211 W Ustick Rd
Boise, ID 837045756
📞 2083753700
Mailing address
979 E Ensolorado St
Kuna, ID 836345179
📞 2086080809

Specialties

  • Occupational Therapy Assistant Primary
    An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has...
    ID license #OTA-1423 taxonomy 224Z00000X

Identifiers

TypeValueNotes
01 340040 NATIONAL BOARD OF OCCUPATIONAL THERAPY

Practice context

Part of a multi-provider practice. 12 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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