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

SHOPKO OPTICAL 089
NPI 1902859531
Eyewear Supplier in Walla Walla, WA

Active since May 17, 2006
1600 W ROSE ST, WALLA WALLA, WA 99362(509) 525-9301 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 089 NPPES

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

SHOPKO OPTICAL 089 (NPI 1902859531) is a healthcare organization registered as an eyewear supplier in Walla Walla, 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

NPI1902859531
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address1600 W ROSE STWalla Walla, WA 99362-1771
Mailing Address1600 W Rose StWalla Walla, WA 99362-1771 · (509) 525-9301
Phone(509) 525-9301
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateJune 5, 2009
✔ NPI 1902859531 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
1600 W ROSE ST, Walla Walla, WA 99362
Open in Google Maps ↗

Other Names 1

Doing Business AsShopko Optical 089

Other Identifiers 12

Other213121-1Eyemed
Other17674Medicare
Medicare PING8860390WA
Other014089Vip
Medicaid2009942WA
OtherWA09207WA · Noridian Submitter Id
Medicare PINDF1015
OtherG8854797Medicare
Other35551Avesis
Medicaid2130268WA
Medicare ID-Type Unspecified1111590047
Medicare NSC5695760116WA

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

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

LUKE ADAM DUNN RPH.
Pharmacist
1600 W ROSE ST
WALLA WALLA, WA 99362
Walla Walla County (509) 525-9207

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 1902859531. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 089.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 1600 W Rose St, Walla Walla, WA 99362. The listed phone number is (509) 525-9301.

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.