Individual
MARA LORIS NYDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
322 W NORTH RIVER DR, SPOKANE, WA 99201-3208
(509) 324-6464
(509) 241-2056
Mailing address
322 W NORTH RIVER DR, SPOKANE, WA 99201-3208
(509) 324-6464
(509) 241-2056
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
MD61384121
WA
208000000X
Pediatrics Physician
4301115052
MI
208000000X
Pediatrics Physician
MD24560
ME
Other
Enumeration date
06/11/2018
Last updated
04/26/2023
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