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

Richard B Hathaway, PAC

Individual provider Physician Assistant · NPI 1710961966

Richard B Hathaway, PAC is a Physician Assistant in Blaine, Minnesota. Licensed in Minnesota. Registered with an NPI since 2005.

Licensed in
MN
In the registry since
2005
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

12175 Aberdeen St NE
Blaine, MN 55449-4717
Phone: (763) 785-4200
Fax: (763) 785-3314
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 9199 (MN)

Record details

NPI number1710961966
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedDecember 1, 2005
Last updated in NPPESJuly 13, 2026

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