NORTHWEST EXTREMITY SPECIALISTS LLC NPI 1477138303

NPI Information

  • NPI: 1477138303
  • Provider Name: NORTHWEST EXTREMITY SPECIALISTS LLC
  • Classification: Clinic/Center - 261QP1100X
  • Specialization: Podiatric
  • Entity Type: Organization
  • CLIA Number: 38D0890672
  • Address: 16770 SW EDY RD STE 318
    SHERWOOD, OR
    ZIP 97140
  • Phone: (503) 245-2420

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NPI Details

NORTHWEST EXTREMITY SPECIALISTS LLC is a podiatric clinic center in Sherwood, OR. NORTHWEST EXTREMITY SPECIALISTS LLC NPI is 1477138303. The provider is registered as an organization entity type.

The provider's business location address is:

16770 SW EDY RD STE 318
SHERWOOD, OR
ZIP 97140-678
Phone: (503) 245-2420
Fax: (503) 245-2445

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 CLIA number assigned to this NPI record is 38D0890672 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 3/11/2021 and was last updated on 3/11/2021.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP1100XClinic/CenterPodiatricYes

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: 11/21/2025

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