Provider Network Agreement

Provider Network Agreement - (Forms/Publications)
Document Information
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Title Provider Network Agreement (60 KB DOC)
Description The provider network agreement for participation in the health care provider network for injured workers covered by Washington State Fund and self-insured employers.
Detail
Form number F245-397-000
Availability
Not available in print
Keywords advanced registered nurse practitioner, chiropractor, dentist, doctor, medical provider, optometrist, osteopathic, osteopathic-physician, physician assistant, podiatrist
Languages English
Valid dates 01-2012
Contact information Join The Network  - - ProvNet@Lni.wa.gov
Join the Network
Web pages Join The Network
Medical Providers

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