Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ethan Jon Blackstone, MFTA

Individual provider Counselor · NPI 1457823411

Ethan Jon Blackstone, MFTA is a Counselor in Bellevue, Washington. Licensed in Washington. Registered with an NPI since 2018.

Licensed in
WA
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

14216 NE 21st St
Bellevue, WA 98007-3720
Phone: (425) 653-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X (WA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1457823411
Entity typeIndividual (Type 1)
GenderMale
Credentials MFTA
Sole proprietorNo
NPI enumeratedDecember 31, 2018
Last updated in NPPESOctober 13, 2020
Certification dateOctober 13, 2020
Mailing address6400 Southcenter Blvd, Tukwila, WA 98188-2547

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