Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Sophia Raelyn Vivant, PA-C

Individual provider Physician Assistant · NPI 1912675216

Sophia Raelyn Vivant, PA-C is a Physician Assistant in Missoula, Montana. Qualified in 2023, 3 years ago. Practices with Rocky Mountain Ear Nose and Throat Center PC, a 20-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Montana.

Years since qualifying
3
Licensed in
MT
In the registry since
2021
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

700 W Kent Ave
Missoula, MT 59801-6772
Phone: (406) 541-3277
Fax: (406) 541-3811
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 2760 Elizabeth Warren Ave Ste A, Butte, MT 59701-3979 — (406) 792-1250
  • 120 S 5th St Ste 104, Hamilton, MT 59840-2798 — (406) 363-3366

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 129044 (MT)

Record details

NPI number1912675216
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 1, 2021
Last updated in NPPESSeptember 18, 2024
Certification dateSeptember 18, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Rocky Mountain Ear Nose And Throat Center Pc — 20 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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