NPI age
2 years
Enumerated 2024-02-01
● Active
Type 1 · Individual
Rilee Wong Mickelsen, PA-C
Mickelsen is 1 of 36 physician assistant providers in Boise and 1 of 97 in Idaho.
Primary specialty
Physician Assistant
Plus 2 subspecialties
Licensed in
ID, PA
2 states
Status
Active
No deactivations on record
Last NPPES update
2024-09-03
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 97 active physician assistant providers in Idaho.
NPI age
2 years
↓ 11 yr below median (13 yr)
State licenses
2 states
Top 76% — 23% of peers are multi-state
Subspecialties
1
In the 56% of peers with subspecialties
NPI lifetime · 2024 → 2026
2024-02Enumerated in NPPES
2024
2026
Where they practice
Practice location
1072 N Liberty St Ste 201
Boise, ID 837048708
Mailing address
Po Box 190930
Boise, ID 837190930
Additional practice locations
1 secondary location on file with NPPES.
Location 2
111 S 11th St Ste 8290
Philadelphia, PA 191074824
Specialties
-
Physician Assistant PrimaryDefinition to come...
-
Physician AssistantDefinition to come...
Practice context
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
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