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Organization

NORTHWEST EXTREMITY SPECIALISTS LLC

Active
Parent organization
NORTHWEST EXTREMITY SPECIALISTS LLC
Other names
NES Happy Valley
Organization subpart
Yes

Provider details

NPI number
Legal business name
NORTHWEST EXTREMITY SPECIALISTS LLC
Authorized official
THOMAS CHARLES MELILLO DPM (OWNER)
(503) 245-2420
Entity
Organization

Contact information

Practice address
16144 SE HAPPY VALLEY TOWN CENTER DR STE 101, HAPPY VALLEY, OR 97086-4257
(503) 245-2420
(503) 245-2445
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
261QP1100X
Podiatric Clinic/Center
Primary

Other

Enumeration date
07/08/2022
Last updated
07/08/2022
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