Organization
COLONIAL OPTICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD MICHAEL JUBIE (OWNER)
(425) 821-1820
Entity
Organization
Contact information
Practice address
12911 120TH AVE NE, SUITE C-80, KIRKLAND, WA 98034-3027
(425) 821-1820
Mailing address
12911 120TH AVE NE, SUITE C-80, KIRKLAND, WA 98034-3027
(425) 821-1820
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OD00003740
WA
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
12/24/2007
Last updated
04/23/2009
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