Healthcare Provider Details

I. General information

NPI: 1740845577
Provider Name (Legal Business Name): DAVID ANTHONY JARA AU.D., CCC-A
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DAVID ANTHONY JARA URETA AU.D., CCC-A

II. Dates (important events)

Enumeration Date: 05/07/2019
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 19TH ST NW STE 308
WASHINGTON DC
20036-3734
US

IV. Provider business mailing address

1931 N CLEVELAND ST APT 511
ARLINGTON VA
22201-4120
US

V. Phone/Fax

Practice location:
  • Phone: 202-785-8704
  • Fax:
Mailing address:
  • Phone: 240-478-0313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD200001253
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2201001725
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: