Individual
HEATHER B. DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3 MONROE PKWY STE U, LAKE OSWEGO, OR 97035-8875
(503) 344-1326
Mailing address
17616 SW BANY RD, BEAVERTON, OR 97007-5707
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT-023603
OR
Other
Enumeration date
10/27/2017
Last updated
10/27/2017
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