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

Lee Self MD PA

Organization Specialist · NPI 1346400744

Lee Self MD PA is a Specialist in Emmett, Idaho. Licensed in Idaho. Registered with an NPI since 2008.

Licensed in
ID
In the registry since
2008
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2020 S Johns Ave Ste B
Emmett, ID 83617-9410
Phone: (208) 425-7507
Fax: (208) 584-9341
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence M7844 (ID)
Primary Care Clinic/Center Taxonomy 261QP2300X

Record details

NPI number1346400744
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lee Self — President · (208) 425-7507
NPI enumeratedJune 10, 2008
Last updated in NPPESMarch 24, 2023
Certification dateMarch 24, 2023
Mailing address23000 Sweet Ola Hwy, Ola, ID 83657-5027

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