MEDICARE: BRIDGE SENSORY CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1093658940
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIDGE SENSORY CENTER LLC

Provider Business Mailing Address
First Line	:	3908 SW DUNIWAY LN
Second Line	:
City	:	GRESHAM
State	:	OR
Zip	:	97080-8780
Country	:	US
Telephone Number	:	503-810-6608
Fax Number	:

Provider Business Practice Location Address
First Line	:	3908 SW DUNIWAY LN
Second Line	:
City	:	GRESHAM
State	:	OR
Zip	:	97080-8780
Country	:	US
Telephone Number	:	503-810-6608
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MUNA YUSUF
Credential	:
Telephone Number	:	503-810-6608

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	05/25/2026

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