Individual
AMANDA GRACE FOGUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSWA, CHW
Contact information
Practice address
132 E BROADWAY STE 431, EUGENE, OR 97401-3158
(541) 321-0517
Mailing address
132 E BROADWAY STE 431, EUGENE, OR 97401-3158
(541) 321-0517
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
A18344
OR
1041C0700X
Clinical Social Worker
Primary
—
OR
172V00000X
Community Health Worker
105155
OR
Other
Enumeration date
04/27/2026
Last updated
07/06/2026
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