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SHOPKO OPTICAL 070
NPI 1073565123
Eyewear Supplier in Spokane Valley, WA

Active since May 17, 2006
13414 E SPRAGUE AVE, SPOKANE VALLEY, WA 99216(509) 924-2015 Get Directions Write a Review

NPPES record last updated: June 5, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shopko Optical 070 NPPES

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

SHOPKO OPTICAL 070 (NPI 1073565123) is a healthcare organization registered as an eyewear supplier in Spokane Valley, Washington and active in the NPI registry since May 2006. The organization lists Michael J Bettiga, Sr. Vice President Health Services, as its authorized official.

NPPES Registry Identity

NPI1073565123
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address13414 E SPRAGUE AVESpokane Valley, WA 99216-0848
Mailing Address13414 E Sprague AveSpokane Valley, WA 99216-0848 · (509) 924-2015
Phone(509) 924-2015
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateJune 5, 2009
✔ NPI 1073565123 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
Also ListedOptometristTaxonomy 152W00000X
Also ListedTechnician/Technologist · OpticianTaxonomy 156FX1800X
13414 E SPRAGUE AVE, Spokane Valley, WA 99216
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Other Names 1

Doing Business AsShopko Optical 070

Other Identifiers 12

OtherG8854794Medicare
Other213121-29Eyemed
Other35546Avesis
Medicare ID-Type Unspecified1111590002
Medicare NSC5695760084WA
Medicare PINDF1015
Medicaid2013142WA
Medicare PING8860389WA
Other014070Vip
Other10829Medicare
OtherWA09206WA · Noridian Submitter Id
Medicaid2005056WA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

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

SHOPKO STORES OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
13414 E SPRAGUE AVE
SPOKANE VALLEY, WA 99216
Spokane County (509) 924-1744
REBECCA JAEL JANGULA OD
Optometrist
13414 E SPRAGUE AVE
SPOKANE VALLEY, WA 99216
Spokane County (509) 924-2015
DR. MARIELLE KWON O.D.
Optometrist
13414 E SPRAGUE AVE
SPOKANE VALLEY, WA 99216
Spokane County (509) 924-2015
MR. JOSEPH E SAMEK RPH
Pharmacist
13414 E SPRAGUE AVE
SPOKANE VALLEY, WA 99216
Spokane County (509) 924-1744

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shopko Stores Operating Co. LLC's NPI number?

The NPI number for Shopko Stores Operating Co. LLC is 1073565123. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 070.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 13414 E Sprague Ave, Spokane Valley, WA 99216. The listed phone number is (509) 924-2015.

What is Shopko Stores Operating Co. LLC's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

When was this NPI record last updated?

The NPPES record for Shopko Stores Operating Co. LLC was last updated on June 5, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.