Douglass Cert Pros & Orthotics, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

PS00000063 Issued in WA

Legal business name

DOUGLASS CERT PROS & ORTHOTICS, INC

Practice address

15225 Aurora Ave N Ste 100
Shoreline, WA 98133-6123

Phone

(206) 363-7790

Fax

(206) 363-7688

NPI assigned

Jun 2, 2006

Organization subpart

Yes

Parent organization

HANGER INCAs reported in NPPES

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

Authorized official

Name

Jennifer L Simmons

Title

Regulatory Compliance Analyst III

Phone

(206) 414-2907

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Douglass Cert Pros & Orthotics, Inc

  • Prosthetic/Orthotic Supplier
  • Renton, WA
  • NPI 1912606583

  9739209925

  Same PAC ID

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

Tax ID family

Douglass Cert Pros Orthotics Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Douglass Cert Pros & Orthotics, Inc

  • Prosthetic/Orthotic Supplier
  • Renton, WA
  • NPI 1912606583
  NPD tax ID

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bryan Gregory Gerhard, CPO, LCPO

  • Prosthetist
  • Shoreline, WA
  • NPI 1790318376

  Orthotist

  NPD
• Glen Stephen Ellis, C.P.O.

  • Specialist
  • Castro Valley, CA
  • NPI 1023156130
  NPD
• J Kirk Douglass, C.P.O.

  • Prosthetist
  • Seattle, WA
  • NPI 1275539264

  Orthotist

  NPD (past)
• Shannon J Kim, CPO, LCPO

  • Prosthetist
  • Seattle, WA
  • NPI 1205469889
  NPD (past)
• Gabrielle Richardson, LCPO

  • Prosthetist
  • Shoreline, WA
  • NPI 1588591333

  Orthotist

  NPD (past)

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784851200000",
    "number": "1992743090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650846",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15225 AURORA AVE N STE 100",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981336123",
            "telephone_number": "206-363-7790",
            "fax_number": "206-363-7688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLASS CERT PROS & ORTHOTICS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HANGER INC",
        "enumeration_date": "2006-06-02",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "REGULATORY COMPLIANCE ANALYST III",
        "authorized_official_telephone_number": "206-414-2907"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "WA",
            "license": "PS00000063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9041328",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jake Arnold Dodge, DPT
• Naomi Faye Doney
• Jenny Lyn Donovan, LMHC
• Thomas Dostal, PTA
• Michelle M Dotsch, D.D.S.
• Dr. Matthew Bell & Associates
• Dr. Michael S. Caparas DMD PC
• Erika Beatrice Drajeske
• Ebrima Dembo Drammeh
• Suzie Driscoll, OT

• Prosthetic/Orthotic Supplier in Shoreline, WA
• Providers in Shoreline, WA by specialty
• Prosthetic/Orthotic Supplier in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.