Organization
NORTHWEST EXTREMITY SPECIALISTS LLC
Active
Parent organization
NORTHWEST EXTREMITY SPECIALISTS LLC
Other names
NES Orthopedics
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHWEST EXTREMITY SPECIALISTS LLC
Authorized official
SHEADAWN FOGERSON (AREA OPERATIONS DIRECTOR)
(503) 352-1313
Entity
Organization
Contact information
Practice address
9445 SW LOCUST ST, TIGARD, OR 97223-6634
(503) 245-2420
Mailing address
9115 SW OLESON RD STE 205, PORTLAND, OR 97223-6877
(503) 245-2420
(503) 245-2445
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174973242
ORTHOPEDIC
CA
Enumeration date
02/06/2023
Last updated
08/30/2023
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