Northwest Extremity Specialists LLC

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

Legal business name

NORTHWEST EXTREMITY SPECIALISTS LLC

Practice address

16144 SE Happy Valley Town Center Dr Ste 101
Happy Valley, OR 97086-4257

Phone

(503) 245-2420

Fax

(503) 245-2445

NPI assigned

Jul 8, 2022

Organization subpart

Yes

Parent organization

NORTHWEST EXTREMITY SPECIALISTS LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Thomas Charles Melillo, DPM

Title

Owner

Phone

(503) 245-2420

Specialties & licenses 1

Addresses

Other names 1

• NES Happy Valley Doing business as

Part of

Northwest Extremity Specialists LLC

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657238400000",
    "number": "1891428587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9115 SW OLESON RD STE 205",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972236877",
            "telephone_number": "503-245-2420",
            "fax_number": "503-245-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16144 SE HAPPY VALLEY TOWN CENTER DR STE 101",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970864257",
            "telephone_number": "503-245-2420",
            "fax_number": "503-245-2445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST EXTREMITY SPECIALISTS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWEST EXTREMITY SPECIALISTS LLC",
        "enumeration_date": "2022-07-08",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A",
        "authorized_official_last_name": "MELILLO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-245-2420",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NES Happy Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phuong Tan My Nguyen
• Victoria Nguyen, PHARM.D
• Lynn Marie Nishida, RPH
• Johnny Nolan, DO
• Northland Hearing Centers, Inc.
• Northwest Primary Care Group PC
• Northwest Primary Care Group PC
• Northwest Primary Care Group, PC
• Kevin E Nufer, MD
• Karla June Nussbaum, IBCLC

• Podiatric Clinic/Center in Happy Valley, OR
• Providers in Happy Valley, OR by specialty
• Podiatric Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.