Get a Form or Publication: Crime Victim Provider
Your search for "Crime Victim Provider" returned 2 documents.
See also
| Title | Type | Number |
|---|---|---|
| Non-Network Provider Application
Includes the F248-036-000 Statewide Payee Registration and W-9 form. For providers to complete that do not want to become a Labor and Industries network provider, or for a specialty that L&I is not accepting network applications for at this time. If you are applying to be a Labor and Industries network provider, please complete application process at www.ProviderNetwork.Lni.wa.gov |
Form | F248-011-000 |
| Master Level Counselor Provider Account Application for Crime Victims
Master Level Counselor Provider Account Application for Crime Victims |
Form | F800-053-000 |
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