Organization
NORTHWEST EXTREMITY SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI T MCCAMMON (ADMINISTRATOR)
(503) 667-6600
Entity
Organization
Contact information
Practice address
831 NW COUNCIL DR STE 203, GRESHAM, OR 97030-3723
(503) 667-6600
(503) 667-6608
Mailing address
6542 SE LAKE RD STE 106, MILWAUKIE, OR 97222-2245
(503) 667-6600
(503) 667-6608
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
332BC3200X
OR
335E00000X
Prosthetic/Orthotic Supplier
Primary
335E00000X
OR
Other
Enumeration date
10/19/2015
Last updated
10/19/2015
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