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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MS. EBONY BLACKMON HUMPHREY DNP ARNP PMHNP-BC
NPI 1669904108
Nurse Practitioner - Psychiatric/Mental Health in Issaquah, WA

Active since April 03, 2017
23205 SE BLACK NUGGET RD, APT J2, ISSAQUAH, WA 98029(206) 701-9363 Get Directions Write a Review

NPPES record last updated: August 10, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 10, 2026, Sep 25, 2019 (2 updates tracked since 2019).

About Ms. Ebony Blackmon Humphrey Dnp Arnp Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. EBONY BLACKMON HUMPHREY DNP ARNP PMHNP-BC (NPI 1669904108) is an individual psychiatric/mental health provider in Issaquah, Washington, licensed in Washington (AP60929540) and active in the NPI registry since April 2017. She maintains a secondary practice location in Vancouver.

NPPES Registry Identity

NPI1669904108
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameMS. EBONY BLACKMON HUMPHREYCredential: DNP ARNP PMHNP-BC
Location Address23205 SE BLACK NUGGET RD, APT J2Issaquah, WA 98029-7326
Mailing Address400 Nw Gilman Blvd Unit 2862Issaquah, WA 98027-0258 · (206) 701-9363
Phone(206) 701-9363
Sole ProprietorYes
Enumeration DateApril 3, 2017
Last NPPES UpdateAugust 10, 20262 updates tracked since enumeration
NPPES CertifiedAugust 10, 2026
✔ NPI 1669904108 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in WA · AP60929540
Also ListedRegistered NurseTaxonomy 163W00000X · License RN60625891 (WA)
Also ListedRegistered Nurse · Case ManagementTaxonomy 163WC0400X · License RN60625891 (WA)
Also ListedRegistered Nurse · Psychiatric/Mental HealthTaxonomy 163WP0808X · License RN60625891 (WA)
23205 SE BLACK NUGGET RD, Issaquah, WA 98029
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Secondary Practice Location 1

Location 16100 NE Fourth Plain BlvdVancouver, WA 98661-6830 · Phone (360) 947-2550

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARITAS CRITICAL CASE MANAGEMENT, LLC
Registered Nurse (Case Management)
23205 SE BLACK NUGGET RD, APT J2
ISSAQUAH, WA 98029
King County (206) 207-9363

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ebony Blackmon Humphrey's NPI number?

The NPI number for Ebony Blackmon Humphrey is 1669904108. It was assigned to this individual provider in the NPPES registry on April 3, 2017.

Where is Ebony Blackmon Humphrey located?

Ebony Blackmon Humphrey practices at 23205 SE Black Nugget Rd Apt J2, Issaquah, WA 98029. The listed phone number is (206) 701-9363.

What is Ebony Blackmon Humphrey's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Ebony Blackmon Humphrey was last updated on August 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.