Roy Gunnar Benson Retlin, CCP

Primary specialty

PerfusionistTaxonomy code 242T00000X

License

1290691319 Issued in MS

Practice address

1959 NE Pacific St
Department of Cardiothoracic Surgery
Seattle, WA 98195-0001

Phone

(206) 598-7401

NPI assigned

Aug 15, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1366875239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 TAYLOR AVE N APT 203",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981092947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "address_2": "DEPARTMENT OF CARDIOTHORACIC SURGERY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "206-598-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETLIN",
        "first_name": "ROY",
        "middle_name": "GUNNAR BENSON",
        "credential": "CCP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-15",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "242T00000X",
            "taxonomy_group": "",
            "desc": "Perfusionist",
            "state": "MS",
            "license": "1290691319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Perfusionist in Seattle, WA
• Providers in Seattle, WA by specialty
• Perfusionist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; 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.