RICHARD B HATHAWAY PAC - NPI 1710961966 - Physician Assistant in Blaine, MN

Q: What is Richard Hathaway's NPI number?

The NPI number for Richard Hathaway is 1710961966. It was assigned to this individual provider in the NPPES registry on December 1, 2005.

Q: What is Richard Hathaway's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Richard Hathaway was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

On this page

About Richard B Hathaway Pac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RICHARD B HATHAWAY PAC (NPI 1710961966) is an individual physician assistant in Blaine, Minnesota, licensed in Minnesota (9199) and active in the NPI registry since December 2005.

NPPES Registry Identity

NPI1710961966

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameRICHARD B HATHAWAYCredential: PAC

Location Address12175 ABERDEEN ST NEBlaine, MN 55449-4717

Mailing Address12175 Aberdeen St NeBlaine, MN 55449-4717 · (763) 785-4200 · Fax (763) 785-3314

Phone(763) 785-4200

Fax(763) 785-3314

Sole ProprietorNo

Enumeration DateDecember 1, 2005

Last NPPES UpdateJuly 13, 2026

✔ NPI 1710961966 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MN · 9199

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

12175 ABERDEEN ST NE, Blaine, MN 55449

Open in Google Maps ↗

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WILLIAM SCOTT SIEVERT MD

Family Medicine