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SHOPKO OPTICAL 092
NPI 1336191311
Eyewear Supplier in Kennewick, WA

Active since May 17, 2006
867 N COLUMBIA CENTER BLVD, KENNEWICK, WA 99336(509) 736-0515 Get Directions Write a Review

NPPES record last updated: June 5, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shopko Optical 092 NPPES

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

SHOPKO OPTICAL 092 (NPI 1336191311) is a healthcare organization registered as an eyewear supplier in Kennewick, 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

NPI1336191311
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address867 N COLUMBIA CENTER BLVDKennewick, WA 99336-7771
Mailing Address867 N Columbia Center BlvdKennewick, WA 99336-7771 · (509) 736-0515
Phone(509) 736-0515
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateJune 5, 2009
✔ NPI 1336191311 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
867 N COLUMBIA CENTER BLVD, Kennewick, WA 99336
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Other Names 1

Doing Business AsShopko Optical 092

Other Identifiers 12

OtherG8855123Medicare
Medicare ID-Type Unspecified0154160081
Medicaid2130250WA
Medicare PING8860389WA
OtherWA07466WA · Noridian Submitter Id
OtherCP2230-56Eyemed
Other014092Vip
Medicare NSC5695760107WA
Other35541Avesis
Other17675Medicare
Medicaid2017721WA
Medicare PINDF1015

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)
867 N COLUMBIA CENTER BLVD
KENNEWICK, WA 99336
Benton County (509) 736-0505
MR. JAMES ARENOLD BALE LICENSED PHARMACIST
Pharmacist
867 N COLUMBIA CENTER BLVD
KENNEWICK, WA 99336
Benton County (509) 736-0505
KATHLEEN PETERSON PHARMD
Pharmacist
867 N COLUMBIA CENTER BLVD
KENNEWICK, WA 99336
Benton County (509) 736-0505
MR. SCOTT EDWARD LAWLESS R.PH.
Pharmacist
867 N COLUMBIA CENTER BLVD
KENNEWICK, WA 99336
Benton County (509) 736-0505

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 1336191311. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 092.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 867 N Columbia Center Blvd, Kennewick, WA 99336. The listed phone number is (509) 736-0515.

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.