MEDICARE: MS. MARGOT HILLARY UNDERWOOD PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA2005-0004	NM
2	363AM0700X	Medical Physician Assistant	PA218220	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508859968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARGOT HILLARY UNDERWOOD PA-C

Provider Business Mailing Address
First Line	:	PO BOX 1517
Second Line	:
City	:	PENDLETON
State	:	OR
Zip	:	97801-0410
Country	:	US
Telephone Number	:	877-708-1119
Fax Number	:	541-278-8349

Provider Business Practice Location Address
First Line	:	147 S 52ND PLACE
Second Line	:
City	:	SPRINGFIELD
State	:	OR
Zip	:	97478-6210
Country	:	US
Telephone Number	:	541-746-1166
Fax Number	:	541-393-1607

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	07/09/2025

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