| Doctor Name: | MR. IVAN SULTAN |
| NPI Number: | 1871506659 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MPT |
| License Number: | 6705 |
| Business Practice Address: | 2265 Exchange St Astoria, OR - 971033331 |
| Business Phone Number: | 5033384005 |
| Business Fax Number: | 5033387557 |
| Mailing Address: | 748 15th St, ASTORIA |
| State: | OR |
| Postal Code: | 971033824 |
| Phone Number: | 5034682469 |
| Fax Number: | 5033387557 |
| NPI Enumeration Date: | 08/14/2006 |
| NPI Last Update Date: | 07/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 6705 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |