OrganizationDr. Heidi ClarkNaturopathOther Service ProvidersPractice Address12195 SW Allen Blvd, Beaverton, OR 97005-4720(503) 646-0697PECOS EnrollmentBased on the most recent information from CMS, provider Dr. Heidi Clark does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1578819900Provider TypeOrganizationFull NameDr. Heidi ClarkSubpartNoEnumeration Date8/3/2012Last Updated8/3/2012Contact InformationPractice LocationPractice Address12195 SW Allen Blvd, Beaverton, OR 97005-4720Phone(503) 646-0697FaxUnlisted FaxMailing LocationMailing Address12195 SW Allen Blvd, Beaverton, OR 97005-4720PhoneUnlisted PhoneFaxUnlisted FaxAuthorized OfficialNameClark, Heidi (Owner)Phone(503) 646-0697Provider TaxonomiesCodeDescriptionLicenseCode175F00000XPrimaryDescriptionNaturopathOther Service ProvidersLicenseUnlisted IssuerCode171100000XDescriptionAcupuncturistOther Service ProvidersLicenseUnlisted Issuer