Colonial Optical LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

COLONIAL OPTICAL LLC

Practice address

12911 120TH Ave NE
Suite C-80
Kirkland, WA 98034-3027

Phone

(425) 821-1820

NPI assigned

Dec 24, 2007

Last updated

Apr 23, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Todd Michael Jubie

Title

Owner

Phone

(425) 821-1820

Specialties & licenses 2

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Donald K Masters, LDO

  • Optician
  • Kirkland, WA
  • NPI 1285722405
  NPD (past)
• David J Pedigo, OD

  • Optometrist
  • Anchorage, AK
  • NPI 1093790701
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240444800000",
    "number": "1659555860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12911 120TH AVE NE",
            "address_2": "SUITE C-80",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343027",
            "telephone_number": "425-821-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12911 120TH AVE NE",
            "address_2": "SUITE C-80",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343027",
            "telephone_number": "425-821-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-24",
        "last_updated": "2009-04-23",
        "status": "A",
        "authorized_official_last_name": "JUBIE",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-821-1820",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003740",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Collie
• Jacob Collins
• Lindsay Collins, M.D.
• Michelle Collins, OT
• Sarah Colon, PT, DPT
• James Stuart Colquhoun Jr., MD
• Howard L Colston, MD
• Katherine Combs
• Samantha Morgan Combs
• Communi-Key Inc

• Eyewear Supplier in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Eyewear Supplier in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.