Individual provider Active NPI

Yenny Yustanto Rosli, MD

  • Internal Medicine Physician
  • Seattle, WA
National Provider Identifier
1700526712
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD.MD.61581488 Issued in WA
Practice address
850 Republican St # 358047
Seattle, WA 98109-4725
Phone
(206) 543-6806
NPI assigned
Mar 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD.MD.61581488 WA Primary

Addresses

Primary practice location

850 Republican St # 358047
Seattle, WA 98109-4725

Mailing address

850 Republican St # 358047
Seattle, WA 98109-4725
Phone (206) 543-6806

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220502000723 WA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2567859028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1700526712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 REPUBLICAN ST # 358047",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981094725",
            "telephone_number": "206-543-6806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 REPUBLICAN ST # 358047",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981094725",
            "telephone_number": "206-543-6806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSLI",
        "first_name": "YENNY",
        "middle_name": "YUSTANTO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD.MD.61581488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.