Individual
AMANDA FOGARTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
711 COMMERCE ST STE 204, TACOMA, WA 98402-4514
(603) 692-8173
Mailing address
5225 BERING ST, GIG HARBOR, WA 98332-9794
(530) 306-5286
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
WA
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/26/2018
Last updated
06/22/2022
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