Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ili Wathen, PA-C

Individual provider Physician Assistant · NPI 1063722577

Ili Wathen, PA-C is a Physician Assistant in Waldorf, Maryland. Licensed in Maryland. Registered with an NPI since 2010.

Licensed in
MD
In the registry since
2010
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

3500 Old Washington Rd Ste 201
Waldorf, MD 20602-3238
Phone: (301) 396-2003
Fax: (240) 222-3134
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence C0004349 (MD)

Record details

NPI number1063722577
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 18, 2010
Last updated in NPPESJuly 28, 2025
Certification dateJuly 28, 2025

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