SHOPKO OPTICAL 081
NPI 1891747879
Eyewear Supplier in Yakima, WA

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

The NPI number for Shopko Stores Operating Co. LLC is 1891747879. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 081.

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

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

Active since May 17, 2006

5801 SUMMITVIEW AVE, YAKIMA, WA 98908(509) 965-6405 Get Directions Write a Review

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

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About Shopko Optical 081 NPPES

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

SHOPKO OPTICAL 081 (NPI 1891747879) is a healthcare organization registered as an eyewear supplier in Yakima, 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

NPI1891747879

Entity TypeOrganization

Primary Taxonomy332H00000X

Legal Business NameSHOPKO STORES OPERATING CO. LLC

Location Address5801 SUMMITVIEW AVEYakima, WA 98908-3006

Mailing Address5801 Summitview AveYakima, WA 98908-3006 · (509) 965-6405

Phone(509) 965-6405

Organization SubpartNo

Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297

Enumeration DateMay 17, 2006

Last NPPES UpdateJune 5, 2009

✔ NPI 1891747879 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

5801 SUMMITVIEW AVE, Yakima, WA 98908

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Other Names 1

Doing Business AsShopko Optical 081

Other Identifiers 11

Medicare NSC5695760075WA

Medicare PING8860390WA

Medicare PINDF1015

Other213121-31Eyemed

Medicare ID-Type Unspecified1111590023

Other014081Vip

OtherWA09208WA · Noridian Submitter Id

Medicaid2007912WA

Other17673Medicare

Medicaid2010312WA

OtherG8854796Medicare

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.

MR. KENNETH KARL ANTLES R.PH.

Pharmacist