KAISER PERMANENTE SKYLINE PHARMACY
NPI 1467491886
Pharmacy - Clinic Pharmacy in Salem, OR

Q: What is Kaiser Foundation Health Plan Of The Northwest's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Clinic Pharmacy, with taxonomy code 3336C0002X.

Active since June 05, 2006CLIA 38D0668653 · Microscopy

5125 SKYLINE RD S, SALEM, OR 97306(866) 280-4583(503) 588-6579 Get Directions Write a Review

NPPES record last updated: June 1, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 1, 2021, Jul 19, 2018, Apr 18, 2018 and 4 more (7 updates tracked since 2016).

On this page

About Kaiser Permanente Skyline Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KAISER PERMANENTE SKYLINE PHARMACY (NPI 1467491886) is a healthcare organization registered as a clinic pharmacy in Salem, Oregon and active in the NPI registry since June 2006. The organization holds a CLIA Microscopy certificate valid through August 19, 2027 and lists Alfred Lyman, Executive Director, Regional Pharma, as its authorized official.

NPPES Registry Identity

NPI1467491886

Entity TypeOrganization

Primary Taxonomy3336C0002X

Legal Business NameKAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST

Location Address5125 SKYLINE RD SSalem, OR 97306-9427

Mailing Address5125 Skyline Rd SSalem, OR 97306-9427 · (866) 280-4583 · Fax (503) 588-6579

Phone(866) 280-4583

Fax(503) 588-6579

Organization SubpartNo

Authorized OfficialAlfred LymanExecutive Director, Regional Pharma · (800) 813-2000

Enumeration DateJune 5, 2006

Last NPPES UpdateJune 1, 20217 updates tracked since enumeration

NPPES CertifiedJune 1, 2021

✔ NPI 1467491886 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Clinic PharmacySuppliers

Taxonomy Code3336C0002X

License✔ Licensed in OR · RP0001106

Definition

A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.

Also ListedPharmacy · Managed Care Organization PharmacyTaxonomy 3336M0003X

5125 SKYLINE RD S, Salem, OR 97306

Open in Google Maps ↗

Other Names 1

Doing Business AsKaiser Permanente Skyline Pharmacy

Other Identifiers 3

Medicaid136734OR

Other2078435Pk

Medicaid6019350WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 38D0668653

Kaiser Permanente Skyline Medical Office Lab · Salem, OR

Active · expires Aug 19, 2027

CLIA Number38D0668653

Laboratory TypePhysician Office

Certificate Effective DateAugust 20, 2025

Certificate Expiration DateAugust 19, 2027

Laboratory DirectorJulia Boncher

Laboratory Phone(503) 571-9147

Laboratory LocationKaiser Permanente Skyline Medical Office Lab5125 Skyline Rd South, Salem, OR 97306

CLIA data matches this NPI record on: Address

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANDREA S HATCHETTE MD

Urology