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Organization

NORTHWEST EXTREMITY SPECIALISTS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
THOMAS CHARLES MELILLO DPM (OWNER)
(503) 245-2420
Entity
Organization

Contact information

Practice address
9115 SW OLESON RD STE 205, PORTLAND, OR 97223-6877
(503) 245-2420
Mailing address
9115 SW OLESON RD STE 205, PORTLAND, OR 97223-6877
(503) 245-2420

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary

Other

Enumeration date
02/12/2015
Last updated
02/08/2021
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