This seems to work. I am now getting a conditional check failed error.
$client->putAttributes(array(
'DomainName' => $domainName,
'ItemName' => $uniqueid,
'Attributes' => array(
array('Name' => 'USER_ID', 'Value' => $uniqueid, 'Replace' => true),
array('Name' => 'EMAIL', 'Value' => $email, 'Replace' => true),
array('Name' => 'CREATED', 'Value' => $date, 'Replace' => true),
array('Name' => 'LAST_UPDATED', 'Value' => $date, 'Replace' => true),
),
'Expected' => array('Name' => 'EMAIL', 'Exists' => false),
));