Individual
HEIDI CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ND, LAC
Contact information
Practice address
4530 SW HALL BLVD, BEAVERTON, OR 97005-0504
(503) 644-6555
Mailing address
4530 SW HALL BLVD, BEAVERTON, OR 97005-0504
(503) 644-6555
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC156029
OR
Other
Enumeration date
11/23/2011
Last updated
05/07/2014
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