SHOPKO OPTICAL 134
NPI 1801848924
Eyewear Supplier in Pullman, WA

Active since May 17, 2006
1450 S GRAND AVE, PULLMAN, WA 99163(509) 332-0820 Get Directions Write a Review

NPPES record last updated: June 5, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shopko Optical 134 NPPES

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

SHOPKO OPTICAL 134 (NPI 1801848924) is a healthcare organization registered as an eyewear supplier in Pullman, 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

NPI1801848924
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address1450 S GRAND AVEPullman, WA 99163-4900
Mailing Address1450 S Grand AvePullman, WA 99163-4900 · (509) 332-0820
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateJune 5, 2009
NPI 1801848924 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
1450 S GRAND AVE, Pullman, WA 99163

Other Names 1

Doing Business AsShopko Optical 134

Other Identifiers 11

Medicaid2019115WA
Medicaid2019388WA
Medicare ID-Type Unspecified0154160248
Medicare PING8860389WA
Other17678Medicare
OtherCP2230-58Eyemed
OtherG8855124Medicare
Other35544Avesis
OtherWA09204WA · Noridian Submitter Id
Medicare NSC5695760078WA
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 5

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

Pharmacist
1450 S GRAND AVE
PULLMAN, WA 99163
Pharmacist
1450 S GRAND AVE
PULLMAN, WA 99163
Optometrist
1450 S GRAND AVE
PULLMAN, WA 99163
Pharmacy (Community/Retail Pharmacy)
1450 S GRAND AVE
PULLMAN, WA 99163
Pharmacist
1450 S GRAND AVE
PULLMAN, WA 99163

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 1801848924. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 134.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 1450 S Grand Ave, Pullman, WA 99163. The listed phone number is (509) 332-0820.

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 with the weekly NPPES data releases published by CMS.