Get the free Provider Account Application (F248-011-000) - L&I - WA.gov
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STATE OF WASHINGTONDEPARTMENT OF LABOR AND INDUSTRIES INSURANCE SERVICES HEALTH SERVICES ANALYSIS PO Box 44261 Olympia Washington 985044261Dear Provider, Thank you for your interest in treating or
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How to fill out provider account application f248-011-000
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Obtain a copy of the provider account application f248-011-000 form.
02
Fill out all required fields accurately and completely.
03
Review the completed application form for any errors or missing information.
04
Submit the filled out application form to the appropriate department or office as specified on the form.
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Wait for confirmation of receipt and further instructions regarding the status of your application.
Who needs provider account application f248-011-000?
01
Individuals or organizations seeking to become providers for a specific service or program that requires the submission of application f248-011-000.
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What is provider account application f248-011-000?
The provider account application f248-011-000 is a form used to apply for a provider account with a specific organization or entity.
Who is required to file provider account application f248-011-000?
Those individuals or entities who wish to become providers with the organization or entity are required to file the provider account application f248-011-000.
How to fill out provider account application f248-011-000?
The provider account application f248-011-000 can be filled out by providing all the required information in the designated fields of the form.
What is the purpose of provider account application f248-011-000?
The purpose of the provider account application f248-011-000 is to establish a provider account with the organization or entity.
What information must be reported on provider account application f248-011-000?
The provider account application f248-011-000 typically requires information such as contact details, services provided, business information, and any relevant certifications or qualifications.
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