NPIMap

Individual provider Active NPI

Elizabeth Nyblade, PH.D.

  • Psychologist
  • Bellingham, WA
National Provider Identifier
1053457333
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY00000535 Issued in WA
Practice address
1116 Key St
Suite 213
Bellingham, WA 98225-5232
Phone
(360) 647-8295
Fax
(360) 647-8296
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PY0000035 WA
Psychologist 103T00000X PY0000035 WA
Family Psychologist 103TF0000X PY00000535 WA
Health Service Psychologist 103TH0100X PY00000535 WA
School Psychologist 103TS0200X PY00000535 WA
Psychologist 103T00000X PY00000535 WA Primary
Clinical Psychologist 103TC0700X PY00000535 WA
Forensic Psychologist 103TF0200X PY00000535 WA

Addresses

Primary practice location

1116 Key St
Suite 213
Bellingham, WA 98225-5232

Mailing address

1116 Key St
Suite 213
Bellingham, WA 98225-5232
Phone (360) 647-8295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY0000035WAMDPsychologist
PY00000535WAMDForensic Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Care Medical Group, Inc. P.S. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1053457333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 KEY ST",
            "address_2": "SUITE 213",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982255232",
            "telephone_number": "360-647-8295",
            "fax_number": "360-647-8296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 KEY ST",
            "address_2": "SUITE 213",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982255232",
            "telephone_number": "360-647-8295",
            "fax_number": "360-647-8296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYBLADE",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "WA",
            "license": "PY0000035",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY0000035",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "WA",
            "license": "PY00000535",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "WA",
            "license": "PY00000535",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "WA",
            "license": "PY00000535",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY00000535",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00000535",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "WA",
            "license": "PY00000535",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.