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Individual

ISRAEL SOSTRIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
5909 SE DIVISION ST STE 3, PORTLAND, OR 97206-1470
(503) 231-3633
(503) 305-4752
Mailing address
PO BOX 10602, PORTLAND, OR 97296-0602
(503) 327-4756
(503) 231-6605

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4725
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3080245-01
FC65, PC65, M/C ADV PPO
OR
01
611036100
US DOL (ACS FISCAL AGENT
OR
01
858185000
BCBSO
OR
01
9317339
PHCS
OR
Enumeration date
07/02/2006
Last updated
08/02/2023
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