Organization Active NPI

Bridgetown Chiropractic and Wellness PC

  • Sports Physician Chiropractor
  • Portland, OR
National Provider Identifier
1407020290
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
273541 Issued in OR
Legal business name
BRIDGETOWN CHIROPRACTIC AND WELLNESS PC
Practice address
7727 NE Glisan St
Portland, OR 97213-6360
Phone
(503) 490-5647
NPI assigned
Apr 14, 2008
Last updated
May 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Authorized official

Name
Dawn L Petricevic
Title
Accounts Manager
Phone
(503) 490-5647

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 273541 OR Primary

Addresses

Primary practice location

7727 NE Glisan St
Portland, OR 97213-6360

Mailing address

7727 NE Glisan St
Portland, OR 97213-6360
Phone (503) 490-5647

Other practice location 1

5828 N Lombard St # B
Portland, OR 97203-4116
Phone (503) 490-5647

Other practice location 2

13327 SE Misty Dr Ste 200
Happy Valley, OR 97086-9309
Phone (503) 490-5647

National Provider Directory

National Provider Directory

Locations

13327 SE Misty Dr
Ste 200
Happy Valley, OR 97086
Phone (503) 490-5647

5828 N Lombard St
#B
Portland, OR 97203
Phone (503) 490-5647

7727 NE Glisan St
Portland, OR 97213
Phone (503) 490-5647

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779926400000",
    "number": "1407020290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7727 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972136360",
            "telephone_number": "503-490-5647",
            "fax_number": "503-254-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7727 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972136360",
            "telephone_number": "503-490-5647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5828 N Lombard St # B",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972034116",
            "country_code": "US",
            "telephone_number": "503-490-5647",
            "fax_number": "503-254-4749",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13327 SE Misty Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Happy Valley",
            "state": "OR",
            "postal_code": "970869309",
            "country_code": "US",
            "telephone_number": "503-490-5647",
            "fax_number": "503-254-4749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRIDGETOWN CHIROPRACTIC AND WELLNESS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-14",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A",
        "authorized_official_last_name": "PETRICEVIC",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ACCOUNTS MANAGER",
        "authorized_official_telephone_number": "503-490-5647"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "OR",
            "license": "273541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; 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.