Provider Demographics
NPI:1043556004
Name:WULFF, EVA DAY (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:EVA
Middle Name:DAY
Last Name:WULFF
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7218 193RD AVE E
Mailing Address - Street 2:
Mailing Address - City:BONNEY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98391-8540
Mailing Address - Country:US
Mailing Address - Phone:253-945-4663
Mailing Address - Fax:253-945-4646
Practice Address - Street 1:33330 8TH AVE S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6325
Practice Address - Country:US
Practice Address - Phone:253-945-2086
Practice Address - Fax:253-945-2177
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-19
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00004543235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist