Provider Demographics
NPI:1588144604
Name:EILAND, SETH BRADLEY (PA-C, CAQ-PSYCH)
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:BRADLEY
Last Name:EILAND
Suffix:
Gender:M
Credentials:PA-C, CAQ-PSYCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 S WASHINGTON ST STE 210
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-3672
Mailing Address - Country:US
Mailing Address - Phone:870-918-9792
Mailing Address - Fax:949-703-7069
Practice Address - Street 1:277 S WASHINGTON ST STE 210
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-3672
Practice Address - Country:US
Practice Address - Phone:870-918-9792
Practice Address - Fax:949-703-7069
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-17
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
VA0110007438363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical