Individual
MS. HEATHER LOCK HEATLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
2216 SE 50TH AVE, PORTLAND, OR 97215-3827
(503) 314-7817
Mailing address
2204 SE 50TH AVE APT 2, PORTLAND, OR 97215-3817
(503) 314-7871
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC000605
OR
Other
Enumeration date
11/28/2006
Last updated
07/08/2007
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