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Ethan Jon Blackstone, MFTA
Student in an Organized Health Care Education/Training Program in Bellevue, Washington
NPI 1457823411

Ethan Jon Blackstone is a Student in an Organized Health Care Education/Training Program based in Tukwila, WA. Ethan Jon Blackstone practices in Bellevue, WA and has the professional credentials of MFTA. The NPI Number for Ethan Jon Blackstone is 1457823411 and holds a License No. (Washington).

The current practice location address for Ethan Jon Blackstone is 14216 Ne 21St St, Bellevue, WA and can be reached out via phone at 425-653-5000. You can also correspond with Ethan Jon Blackstone through the mailing address at 6400 SOUTHCENTER BLVD, TUKWILA, WA - 98188-2547 (mailing address contact number: ).

Location: 14216 Ne 21St St, Bellevue, WA, 98188-2547
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1457823411
Provider Name
Ethan Jon Blackstone
Credential
MFTA
Provider Entity Type
Individual
Gender
Male
Address
14216 Ne 21St St, Bellevue, WA, 98188-2547
Phone Number
425-653-5000
Fax Number
Provider Enumeration Date
12/31/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
14216 Ne 21St St
City
Bellevue
State
Washington
Zip
98007-3720
Phone Number
425-653-5000
Fax Number
person
Provider Business Mailing Address Details
Address
14216 Ne 21St St
City
Bellevue
State
Washington
Zip
98007-3720
Phone Number
425-653-5000
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
()
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
(Washington)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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