NPIMap

Organization Active NPI

Preferred Orthotic and Prosthetic Services Inc

Doing business as Evergreen Prosthetics and Orthotics

  • Prosthetic/Orthotic Supplier
  • Federal Way, WA
National Provider Identifier
1689713265
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
PREFERRED ORTHOTIC AND PROSTHETIC SERVICES INC
Doing business as
Evergreen Prosthetics and Orthotics
Practice address
922 S 348TH St
Federal Way, WA 98003-7021
Phone
(253) 952-3887
Fax
(253) 927-3058
NPI assigned
Feb 6, 2007
Last updated
May 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Authorized official

Name
Timothy L O'Neill, CPONPI 1700400249
Title
Owner
Phone
(503) 407-5408

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X NU Primary

Addresses

Primary practice location

922 S 348TH St
Federal Way, WA 98003-7021

Mailing address

911 Main St Ste 100
Oregon City, OR 97045-1853
Phone (503) 765-5081

Other identifiers 1

IdentifierTypeStateIssuer
1689713265MedicaidWA

Other names 1

  • Evergreen Prosthetics and Orthotics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930090674 WA DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 1254451529 Practice locations: Federal Way, WA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Preferred Orthotic and Prosthetic S922 S 348TH St, Federal Way, WA 98003-7021(253) 952-3887 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Does not accept assignmentParticipating since Jan 1, 2023

National Provider Directory

National Provider Directory
Tax ID family
Preferred Orthotic PR3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

34709 9th Ave S
Ste A100
Federal Way, WA 98003
Phone (253) 952-3887

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779062400000",
    "number": "1689713265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 MAIN ST STE 100",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451853",
            "telephone_number": "503-765-5081",
            "fax_number": "971-316-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 S 348TH ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980037021",
            "telephone_number": "253-952-3887",
            "fax_number": "253-927-3058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED ORTHOTIC AND PROSTHETIC SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A",
        "authorized_official_last_name": "O'NEILL",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-407-5408",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689713265",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Prosthetics and Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.