1. Home
  2. Directory
  3. Washington
  4. Wenatchee
  5. Eyewear Supplier
  6. NPI Profile

SHOPKO OPTICAL 122
NPI 1386696383
Eyewear Supplier in Wenatchee, WA

Active since May 17, 2006
1340 N WENATCHEE AVE, WENATCHEE, WA 98801(509) 663-8868 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 122 NPPES

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

SHOPKO OPTICAL 122 (NPI 1386696383) is a healthcare organization registered as an eyewear supplier in Wenatchee, 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

NPI1386696383
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address1340 N WENATCHEE AVEWenatchee, WA 98801-1558
Mailing Address1340 N Wenatchee AveWenatchee, WA 98801-1558 · (509) 663-8868
Phone(509) 663-8868
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateJune 5, 2009
✔ NPI 1386696383 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
1340 N WENATCHEE AVE, Wenatchee, WA 98801
Open in Google Maps ↗

Other Names 1

Doing Business AsShopko Optical 122

Other Identifiers 11

Other014122Vip
OtherG8855121Medicare
Medicare PINDF1015
OtherWA09230WA · Noridian Submitter Id
Medicare ID-Type Unspecified0154160185
Other35552Avesis
Medicaid2016731WA
Other17677Medicare
OtherCP2230-60Eyemed
Medicare NSC5695760104WA
Medicare PING8860390WA

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.

DR. TRAVIS IKSIC PHARMD
Pharmacist
1340 N WENATCHEE AVE
WENATCHEE, WA 98801
Chelan County (509) 664-5111
MS. DONNA MARIE MELLISON PHARMACIST MANAGER
Pharmacist
1340 N WENATCHEE AVE
WENATCHEE, WA 98801
Chelan County (509) 664-5111
DR. GLENN H ISAACSON O.D.
Optometrist
1340 N WENATCHEE AVE
WENATCHEE, WA 98801
Chelan County (509) 663-8868
SHOPKO STORES OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
1340 N WENATCHEE AVE
WENATCHEE, WA 98801
Chelan County (509) 664-5111

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 1386696383. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 122.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 1340 N Wenatchee Ave, Wenatchee, WA 98801. The listed phone number is (509) 663-8868.

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.