Non-Network Provider Application
También vea
| Información del documento | ||
 Obtenga ayuda para descargar e imprimir archivos.  Cómo completar formularios electrónicos. |
||
| Título |
Non-Network Provider Application (Un formulario electrónico)- 517 KB PDF) |
|
| Descripción | 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 |
|
| Detalle | ||
| Número del formulario | F248-011-000 | |
| Disponibilidad | ordénelo | |
| Palabras claves | crime victim provider, doctor, interpreter, medical provider, most requested forms, physician assistant, provider application | |
| Idiomas | English | |
| Fechas válidas | 01-2013 | |
| Contacto | ||
| Páginas de Internet | For Medical Providers | |
© Depto. de Labor e Industrias del Estado de Washington. El uso de éste sitio del Internet está sujeto a las leyes del Estado de Washington.