Provider Demographics
NPI:1073886404
Name:JUDAY, AMY (MA, CF-SLP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:JUDAY
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22109 108TH AVE E
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-8871
Mailing Address - Country:US
Mailing Address - Phone:253-683-6400
Mailing Address - Fax:
Practice Address - Street 1:22109 108TH AVE E
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-8871
Practice Address - Country:US
Practice Address - Phone:253-683-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-15
Last Update Date:2014-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASI 60336056235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist