Bridgeton Chiropractic, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

5143 Issued in OR

Legal business name

BRIDGETON CHIROPRACTIC, LLC

Practice address

10350 N Vancouver Way # 92
Portland, OR 97217-7530

Phone

(971) 255-1708

Fax

(971) 255-0865

NPI assigned

Jul 15, 2015

Last updated

Jul 15, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Julia Evelyn Wilber, DCNPI 1801239884

Title

Owner/Manager

Phone

(971) 255-1708

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Julia Evelyn Wilber, D.C.

  • Chiropractor
  • Portland, OR
  • NPI 1801239884
  NPD (past) Authorized official

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436918400000",
    "number": "1174907638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 N VANCOUVER WAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972177530",
            "telephone_number": "971-255-1708",
            "fax_number": "971-255-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10350 N VANCOUVER WAY # 92",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972177530",
            "telephone_number": "971-255-1708",
            "fax_number": "971-255-0865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGETON CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-15",
        "last_updated": "2015-07-15",
        "status": "A",
        "authorized_official_last_name": "WILBER",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "EVELYN",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "971-255-1708",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "OR",
            "license": "5143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801239884",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Bridgetown Medical Group P.C. (Bridgetown Women'c Care)

• Medical Specialty Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Medical Specialty Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.