# LAKE HILLS MEDICAL ASSOC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740260892
- **Authorized official:** AMY L LARSON (OFFICE MANAGER)
- **Authorized official phone:** (208) 798-8968

## Contact information

- **Practice address:** 14858 LAKE HILLS BLVD, BELLEVUE, WA 98007-5821
- **Practice address phone:** (208) 816-1332
- **Mailing address:** 1525 BURRELL DR, LEWISTON, ID 83501-5827
- **Mailing address phone:** (208) 816-1332

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD00015580 | WA | Yes |

## Other

- **Enumeration date:** 01/17/2006
- **Last updated:** 01/07/2011