If you are not a provider that is required to join our network to give ongoing care to injured workers, or if you practice out-of-state, here's what you need to do to become a non-network provider for L&I:

Apply for an account number

• Complete a Provider Account Application and Form W-9.
• Submit your completed application:

  Mail: Provider Credentialing PO Box 44261 Olympia, WA 98504-4261

  Fax: 360-902-4484

We will review your application

If you are accepted, you will receive a provider account number and a CD with additional information.

If you are one of the following provider types, review and fulfill the unique requirements

• Home-modification provider
• Independent medical examiner
• Interpreter
• Vocational provider
• Work-hardening provider