Provider Demographics
NPI:1730316753
Name:RAWN, CAITLIN (AUD)
Entity Type:Individual
Prefix:MS
First Name:CAITLIN
Middle Name:
Last Name:RAWN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 116TH AVE NE
Mailing Address - Street 2:AUDIOLOGY M/S CB-12
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3829
Mailing Address - Country:US
Mailing Address - Phone:206-884-5467
Mailing Address - Fax:
Practice Address - Street 1:1500 116TH AVE NE
Practice Address - Street 2:AUDIOLOGY M/S CB-12
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3829
Practice Address - Country:US
Practice Address - Phone:206-884-5467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE900756237600000X
MO2010023075231H00000X
WA60325216231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO152360312Medicare PIN