Update Your Account

Prevent delays in authorization and payment by maintaining your information. Please report changes to your account within 14 calendar days.

How to update your account with L&I
If you are a: And your tax id (EIN) changes: And your address or business status changes:
Network provider
  1. Update page two of the Washington Practitioner Application (658 KB DOC).
  2. Submit your new W-9 form.
Notify us using the Provider Change Form.
Non-network provider

Update your Provider Account Application and submit your new W-9 form (combined).

IME Provider
  1. Update your IME Provider Account Application and submit your new W-9 form (combined).
  2. Complete the Approved IME Examiner Update form.
Notify us using the Approved IME Examiner Update form.

Send change request to:

Fax: 360-902-4563
Mail:
Provider Credentialing & Compliance
PO Box 44621
Olympia WA 98504-4161

Verify your account listing in Find a Doctor to ensure injured workers and other providers can find you.

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