Caitlin Quinn Rayborn, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

61415778 Issued in WA

Practice address

3516 12TH Ave NE
Olympia, WA 98506-5218

Phone

(360) 456-1600

Fax

(360) 456-6504

NPI assigned

Sep 24, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Caitlin Quinn Nichols Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: crayborn@pawa.pcc-direct.com
• Direct secure messaging: cnichols455733@direct.healthsystem.virginia.edu

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

• Providence Health & Services Washington

  dba Providence St Peter Hospital

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1346250594
  NPD (past)
• South Sound Pediatrics PLLC

  • Pediatrics Physician
  • Olympia, WA
  • NPI 1073684692
  NPD (past)

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1942784145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3516 12TH AVE NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065218",
            "telephone_number": "360-456-1600",
            "fax_number": "360-456-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3516 12TH AVE NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065218",
            "telephone_number": "360-456-1600",
            "fax_number": "360-456-6504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393098",
            "country_code": "US",
            "telephone_number": "503-494-8311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1215 Lee St Mail Stop",
            "address_2": "#800501",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "22908",
            "country_code": "US",
            "telephone_number": "434-924-5321",
            "fax_number": "434-982-3816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAYBORN",
        "first_name": "CAITLIN",
        "middle_name": "QUINN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-24",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116034460",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "61415778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAITLIN",
            "last_name": "NICHOLS",
            "middle_name": "QUINN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Roni Ann Rave, CDP
• Eileen M Ravella, PA-C
• Resa Eileen Raven, PSY.D.
• Leanne Frances Rawson, PT,DPT
• David Jonathon Ray, LMP
• Dale Ann Rayburn, LPN
• RCM Enterprise, LLC
• Marshall L. Rea, D.O.
• Remedy Ruby Moon Rea
• Krista Mae Lynett Reagan, M.D.

• Pediatrics Physician in Olympia, WA
• Providers in Olympia, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.