Healthcare Provider Details

I. General information

NPI: 1851217947
Provider Name (Legal Business Name): BRIDGEPORT MRI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7591 SW MOHAWK ST
TUALATIN OR
97062-9189
US

IV. Provider business mailing address

9200 SE 91ST AVE STE 330
HAPPY VALLEY OR
97086-3756
US

V. Phone/Fax

Practice location:
  • Phone: 503-639-9700
  • Fax: 503-639-9710
Mailing address:
  • Phone: 503-477-5733
  • Fax: 503-477-5924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DARCY E ORIN
Title or Position: CFO
Credential:
Phone: 503-774-7700