Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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MS. Skye Gustin Waggoner, PA-C

Individual provider Physician Assistant · NPI 1750538310

MS. Skye Gustin Waggoner, PA-C is a Physician Assistant in Salem, Oregon. Qualified in 2008, 18 years ago. Practices with Kaiser Foundation Health Plan of the Northwest, a 1,811-clinician group and accepts Medicare assignment.

Years since qualifying
18
In the registry since
2008
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3896 Beverly Ave NE Bldg J Ste 40
Salem, OR 97305-1374
Phone: (503) 588-0076
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1750538310
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 25, 2008
Last updated in NPPESAugust 25, 2008
Mailing address3896 Beverly Ave Ne, Bldg J, Ste 40, Salem, OR 97305-1374

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Kaiser Foundation Health Plan Of The Northwest — 1811 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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