Individual
MARK ANDREW NYBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
820 S MCCLELLAN ST STE 118, SPOKANE, WA 99204-2446
(509) 388-7100
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/14/2021
Last updated
11/03/2022
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