Organization
DR. HEIDI CLARK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI CLARK (OWNER)
(503) 646-0697
Entity
Organization
Contact information
Practice address
12195 SW ALLEN BLVD, BEAVERTON, OR 97005-4720
(503) 646-0697
Mailing address
12195 SW ALLEN BLVD, BEAVERTON, OR 97005-4720
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
—
—
175F00000X
Naturopath
Primary
—
—
Other
Enumeration date
08/03/2012
Last updated
08/03/2012
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