Northwest Extremity Specialists LLC

NPI #1669057592 in Newberg, Oregon

Provider Information

NPI Number
1669057592
Entity Type
Organization
Organization Name
Northwest Extremity Specialists LLC
Subpart
Yes (part of a larger organization)
Parent Organization
NORTHWEST EXTREMITY SPECIALISTS LLC
Primary Specialty
Clinic/Center - Podiatric
Enumeration Date
Mar 11, 2021
Last Updated
Mar 11, 2021

Practice Location

Address
1000 N PROVIDENCE DR STE 320
State
Oregon
ZIP Code
97132-7582
Phone
(503) 245-2420

Authorized Official

Name
THOMAS CHARLES MELILLO, DPM
Title
OWNER
Phone
(503) 245-2420

Specialties & Taxonomy Codes

Specialty
Clinic/Center - PodiatricPodiatric

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