=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275495624
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HELIX SPORTS THERAPY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/24/2025
-----------------------------------------------------
Last Update Date | 11/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8215 SW TUALATIN SHERWOOD RD STE 200
-----------------------------------------------------
City | TUALATIN
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97062-8620
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-514-9633
-----------------------------------------------------
Fax | 714-514-9633
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7595 ZINFANDEL ST NE
-----------------------------------------------------
City | KEIZER
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97303-3878
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-514-9633
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPORTS MEDICINE MASSAGE THERAPIST
-----------------------------------------------------
Name | HEATHER B DAVENPORT
-----------------------------------------------------
Credential | LMT
-----------------------------------------------------
Telephone | 714-514-9633
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2081S0010X
-----------------------------------------------------
Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------