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Contact Information

COLONIAL OPTICAL LLC
12911 120TH AVE NE
SUITE C-80
KIRKLAND, WA98034-3027
 Phone: 425-821-1820
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Eyewear Supplier

332H00000X 87 All Other Suppliers
 

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for COLONIAL OPTICAL LLC

NPI Number 1659555860
LBN Legal business name COLONIAL OPTICAL LLC
Authorized official TODD JUBIE - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/24/2007
Last updated 04/23/2009 - About 17 years ago
Identifiers
WA License # OD00003740
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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