Provider Demographics
NPI:1851004147
Name:WILLOW TREE CASE MANAGEMENT LLC
Entity Type:Organization
Organization Name:WILLOW TREE CASE MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEFFANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTENBERN
Authorized Official - Suffix:
Authorized Official - Credentials:DHSC, LMSW, QMHP-R
Authorized Official - Phone:503-995-6351
Mailing Address - Street 1:PO BOX 2511
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-2511
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10249 SW SUSQUEHANNA DR
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-9586
Practice Address - Country:US
Practice Address - Phone:307-631-4087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-02
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty