Healthcare Provider Details

I. General information

NPI: 1730316753
Provider Name (Legal Business Name): CAITLIN RAWN AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2009
Last Update Date: 02/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 116TH AVE NE AUDIOLOGY M/S CB-12
BELLEVUE WA
98004-3829
US

IV. Provider business mailing address

1500 116TH AVE NE AUDIOLOGY M/S CB-12
BELLEVUE WA
98004-3829
US

V. Phone/Fax

Practice location:
  • Phone: 206-884-5467
  • Fax:
Mailing address:
  • Phone: 206-884-5467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number900756
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2010023075
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number60325216
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: