Individual
AMANDA GRACE FOGUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CHW
Contact information
Practice address
599 E BROADWAY, EUGENE, OR 97401-0006
(541) 972-2133
Mailing address
599 E BROADWAY, EUGENE, OR 97401-0006
(541) 972-2133
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
105155
OR
Other
Enumeration date
04/27/2026
Last updated
04/27/2026
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