Organization
FANNO CREEK HEALING ARTS LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI CLARK (ND, LAC)
(503) 277-3699
Entity
Organization
Contact information
Practice address
4530 SW HALL BLVD, BEAVERTON, OR 97005-0504
(503) 277-3699
Mailing address
4530 SW HALL BLVD, BEAVERTON, OR 97005-0504
(503) 277-3699
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
3156
OR
171100000X
Acupuncturist
AC156029
OR
175F00000X
Naturopath
Primary
1881
OR
Other
Enumeration date
11/23/2012
Last updated
11/23/2012
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