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General NPI Number Information
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NPI Number | 1568361475
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Entity Type | Organization
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Legal Business Name | SPRINGTREE COUNSELING & CONSULTING, LLC
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Dates
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Enumeration Date | 11/05/2026
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Last Update Date | 11/05/2026
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Provider Practice Location Address
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Address Line | 1535 SE 29TH AVE UNIT 7
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City | PORTLAND
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State | OR
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Zip | 97214-4970
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Country | US
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Telephone | 503-683-1704
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Fax |
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Provider Business Mailing Address
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Address Line | 1535 SE 29TH AVE UNIT 7
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City | PORTLAND
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State | OR
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Zip | 97214-4970
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Country | US
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Telephone | 503-683-1704
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Fax |
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Authorized Official
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Title or Position | OWNER, CLINICAL DIRECTOR
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Name | SHANE FORTNER
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Credential | PHD, LPC, LMHC
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Telephone | 503-683-1704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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