Active NPI
Elisa Youngblood, PH.D.
- Clinical Psychologist
- Olympia, WA
National Provider Identifier
1689703498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY0309
- Practice address
- 4225 Briggs Dr SE Apt A101
Olympia, WA 98501-4145 - Phone
- (907) 617-0169
- NPI assigned
- Mar 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY0309 | NV | Primary |
Addresses
Primary practice location
4225 Briggs Dr SE Apt A101
Olympia, WA 98501-4145
Mailing address
4225 Briggs Dr SE Apt A101
Olympia, WA 98501-4145
Phone (907) 617-0169
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
| License | State | Type | Specialty |
|---|---|---|---|
| PY0309 | NV | MD | Clinical Psychologist |
| 568 | AK | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773273600000",
"number": "1689703498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4225 BRIGGS DR SE APT A101",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985014145",
"telephone_number": "907-617-0169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4225 BRIGGS DR SE APT A101",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985014145",
"telephone_number": "907-617-0169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNGBLOOD",
"first_name": "ELISA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-05",
"last_updated": "2026-03-12",
"certification_date": "2026-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NV",
"license": "PY0309",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.