NPI 1154896363

Jacquelyn Tyra, OD

Practitioner Optometrist Ashburn, VA

Practice location

Address: 43490 Yukon Dr STE 200, Ashburn, VA 20147-7315
Phone: (703) 724-0330
Mailing address: 21735 Pinewood CT, Sterling, VA 20164-2300

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 0618002779 (VA)

Other Optometrist providers in Virginia →

Registry record

NPI: 1154896363
Entity type: Individual
Sex (as registered): Female
NPI issued: 4 Oct 2018
Record last updated: 23 May 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.