NPIMap

Individual provider Active NPI

Jennifer Raynsford

  • Physician Assistant
  • Woodburn, OR
National Provider Identifier
1063231231
Registry record updated Oct 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
222719 Issued in OR
Practice address
1848 Killian Spring Dr
Woodburn, OR 97071-5912
Phone
(415) 577-8482
NPI assigned
Oct 5, 2024
Last updated
Oct 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 222719 OR Primary

Addresses

Primary practice location

1848 Killian Spring Dr
Woodburn, OR 97071-5912

Mailing address

1848 Killian Spring Dr
Woodburn, OR 97071-5912
Phone (415) 577-8482

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260121001157 OR Practitioner - Physician Assistant 3577040625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3020 S Nectarine St
Cornelius, OR 97113-6104

PO Box
Suite 6149
Aloha, OR 97007

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
222719ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Garcia Memorial Health Center CurrentSince Jan 8, 2026 Accepting new patients
Virginia Garcia Memorial Health Center CurrentSince Jan 8, 2026 Accepting new patients
Virginia Garcia Memorial Health Center Past Accepting new patients

Locations

2725 SW Cedar Hills Blvd
Ste 200
Beaverton, OR 97005
Phone (503) 352-6000

232 SE 7th Ave
Hillsboro, OR 97123
Phone (503) 640-1614

Interoperability endpoints

  • Direct secure messaging: jraynsford296105@direct.ochin.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1728086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728086400000",
    "number": "1063231231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1848 KILLIAN SPRING DR",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "970715912",
            "telephone_number": "415-577-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1848 KILLIAN SPRING DR",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "970715912",
            "telephone_number": "415-577-8482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYNSFORD",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-05",
        "last_updated": "2024-10-05",
        "certification_date": "2024-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "222719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodburn, OR

Sources for this page

Verify at the official NPI Registry.