Individual provider Active NPI

Jerry Yuan, D.O.

  • Dermatology Physician
  • Bremerton, WA
National Provider Identifier
1992902662
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0102206282 Issued in VA
Practice address
Naval Hospital Bremerton
One Boone Rd
Bremerton, WA 98312
Phone
(360) 475-5115
NPI assigned
Jun 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X OP70075807 WA
Dermatology Physician 207N00000X 0102206282 VA Primary
Military Health Care Provider 171000000X

Addresses

Primary practice location

Naval Hospital Bremerton
One Boone Rd
Bremerton, WA 98312

Mailing address

Naval Hospital Bremerton
One Boone Rd
Bremerton, WA 98312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20140306000033 MD Order and Referring Only - DermatologyPractitioner - Dermatology 9931339280

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Michigan Medical School, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1825 E 19TH St
The Dalles, OR 97058-3365

2550 NE Ariel CT
Poulsbo, WA 98370-6534

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102206282VAMDDermatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1992902662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL HOSPITAL BREMERTON",
            "address_2": "ONE BOONE RD",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "98312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL HOSPITAL BREMERTON",
            "address_2": "ONE BOONE RD",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "98312",
            "telephone_number": "360-475-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUAN",
        "first_name": "JERRY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "OP70075807",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0102206282",
            "primary": true
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

Verify at the official NPI Registry.