Individual
DR. JOSEPH ROBERT COLELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
15821 SR 525, SUITE 1, LANGLEY, WA 98260-9780
(360) 321-4779
(360) 321-4782
Mailing address
15821 SR 525, SUITE 1, LANGLEY, WA 98260-9780
(360) 321-4779
(360) 321-4782
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
60279998
WA
152W00000X
Optometrist
741
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
483055
—
MT
Enumeration date
09/28/2006
Last updated
07/12/2012
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