Healthcare Provider Details

I. General information

NPI: 1275495624
Provider Name (Legal Business Name): HELIX SPORTS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 11/24/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8215 SW TUALATIN SHERWOOD RD STE 200
TUALATIN OR
97062-8620
US

IV. Provider business mailing address

7595 ZINFANDEL ST NE
KEIZER OR
97303-3878
US

V. Phone/Fax

Practice location:
  • Phone: 714-514-9633
  • Fax: 714-514-9633
Mailing address:
  • Phone: 714-514-9633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: HEATHER B DAVENPORT
Title or Position: SPORTS MEDICINE MASSAGE THERAPIST
Credential: LMT
Phone: 714-514-9633