Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lisa Marie Hathaway, PA-C, RD

Individual provider Physician Assistant · NPI 1578152427

Lisa Marie Hathaway, PA-C, RD is a Physician Assistant in Missoula, Montana. Works from 2 locations. Licensed in Montana and Nevada.

Licensed in
MT, NV
In the registry since
2021
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.
RD — Registered Dietitian
A credentialed nutrition professional.

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Practice location Address checks out

2819 Great Northern Loop Ste 100
Missoula, MT 59808-1750
Phone: (406) 282-3495
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 445 W Alder St, Missoula, MT 59802-4121 — (406) 282-3495

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence MED-PAC-LIC-94043 (MT)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 1176977 (NV)
Registered Dietitian Taxonomy 133V00000X · Licence 86048867 (MT)

Record details

NPI number1578152427
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C , RD
Sole proprietorNo
NPI enumeratedJanuary 14, 2021
Last updated in NPPESOctober 15, 2025
Certification dateOctober 15, 2025

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