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General NPI Number Information
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NPI Number | 1144292582
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Entity Type | Individual
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Provider Name | AMY B MARGOLIS PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 03/20/2024
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Provider Practice Location Address
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Address Line | 2195 NW SHEVLIN PARK RD
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City | BEND
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State | OR
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Zip | 97703-7102
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Country | US
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Telephone | 541-706-3843
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Fax | 541-278-8375
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Provider Business Mailing Address
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Address Line | PO BOX 1517
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City | PENDLETON
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State | OR
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Zip | 97801-0410
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Country | US
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Telephone | 541-278-4332
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Fax | 541-278-8349
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA 60026246
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA216394
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License Number State | OR
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