Provider Demographics
NPI:1447411384
Name:WULFF, EMILY JANE (ARNP, NNP-BC)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:JANE
Last Name:WULFF
Suffix:
Gender:F
Credentials:ARNP, NNP-BC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:JANE
Other - Last Name:COMBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:272 COWLITZ PL
Mailing Address - Street 2:
Mailing Address - City:LA CONNER
Mailing Address - State:WA
Mailing Address - Zip Code:98257-9606
Mailing Address - Country:US
Mailing Address - Phone:360-600-3041
Mailing Address - Fax:
Practice Address - Street 1:4805 NE GLISAN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2933
Practice Address - Country:US
Practice Address - Phone:503-215-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP 60029715363LN0000X, 363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
No363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8878195Medicare PIN
WAG8874290Medicare PIN