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NORTHWEST EXTREMITY SPECIALISTS LLC NPI 1295126241


NPI Information

NPI: 1295126241
Provider Name: NORTHWEST EXTREMITY SPECIALISTS LLC
Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
9115 SW OLESON RD STE 205
PORTLAND, OR
ZIP 97223
Phone: (503) 245-2420
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NORTHWEST EXTREMITY SPECIALISTS LLC is a podiatrist in Portland, OR. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. NORTHWEST EXTREMITY SPECIALISTS LLC NPI is 1295126241. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9115 SW OLESON RD STE 205
PORTLAND, OR
ZIP 97223-877
Phone: (503) 245-2420

The provider's authorized official is Thomas Charles Melillo .
The authorized official title is Owner and has the following contact phone number (503) 245-2420.

The enumeration date for this NPI number is 2/12/2015 and was last updated on 2/8/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1213E00000XPodiatristYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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