The town had originally organized in December 1888, but after Washington became a state in 1889, it had to incorporate under the state's new laws. In that same June 7, 1890 election, voters also elected Medical Lake's first city officers. Stanley Hallett (1851-1926), one of the city's early settlers and a former English aristocrat, was elected the town's first mayor.
The town elected the following as its first councilmen: Charles Bloomer, John Campbell, A. W. Green, J. H. Lefevre, and Christian Dittmer. The town's first treasurer was J. M. Landis and the first clerk was M. L. Fienberg.
Hallett, after his mayoral stint, would go on to become city treasurer for eight consecutive years. He would also serve as a county commissioner and a state senator. Subsequent early mayors would include Charles Bloomer, G. L. Moss. and Andrew Peat.