As of January 2013, certain medical providers must be in our network to care for injured workers (including those employed by self-insured businesses) beyond the initial office or emergency-room visit.
Find out whether you need to join, and how to apply:
| Physician | |
| Chiropractor | |
| Naturopathic Physician | |
| Advanced Nurse Practitioner | |
| Podiatric Physician or Surgeon | |
| Physician Assistant | |
| Dentist | |
| Optometrist | |
| Other (including massage therapists, physical therapists, occupational therapists, speech therapists, psychologists, and others) |
| Pathologist | |
| Emergency room provider | |
| Hospitalist | |
| Consulting radiologist in a hospital radiology department | |
| Anesthesiologist or certified registered nurse anesthetist (CRNA) not in a hospital-based pain-management practice | |
| None of the Above |
Do not apply to join the network.
You can continue to treat injured workers without joining the network, but you must have an L&I provider number, which is required of everyone that does business with L&I.
Don't have an L&I provider number yet?
In future years, L&I will require other provider types to join the network.
Until then you can continue to treat injured workers without joining.
In order to be paid for treating injured workers beyond an initial visit, you will need to join our network.
How would you like to apply?
Apply online
with ProviderSource
(Recommended)
Apply on paper
You are not required to join our network,
but we encourage you to apply.
There are 2 ways:
Apply online
with ProviderSource
(Recommended)
Apply on paper
How to apply online with ProviderSource
- Using the 'Apply Online' button below, go to the OneHealthPort site, then follow the printable 'Getting Started' instructions there to set up your OneHealthPort account correctly.
- Once your account is set up, complete the:
- Washington Practitioner Application (WPA)
- Give access to L&I by checking the box in the Attestation tab. Only practitioners can personally do this step.
- Read and sign the:
- Provider Network Agreement
- Return to this page. For each location or tax ID that you have, complete a: Download, fill out, print, and sign, then fax or mail to the address on the form.
How to apply on paper
Download, complete, print, and sign the 3 parts of the application:
- Washington Practitioner Application (658 KB DOC)
You can either:
- Complete a new WPA, or
- Update a recent copy of the WPA that you already have. If it is a 2009 form or older, you'll need to send us some extra information as well.
- Provider Network Agreement
- Statewide Payee Registration and W-9 - Submit one form for each location/tax ID you have.
Fax or mail all 3 documents together to us:
Fax: 360-902-4563 |
Mail: Provider CredentialingPO Box 44261 Olympia, WA 98504-4261 |
What's the status of my application?
Why should I join?
If you're a type of provider that we're asking to join the network, and you don't apply, we can only pay you for initial office or emergency room visits, as of Jan. 2013.
What happens if I don't join?
If you're a type of provider that we're asking to join the network, and you don't join, you can still treat injured workers for the initial visit, but you will need to transfer those that need ongoing care.
Questions?
- Common questions about the network.
- Email us: ProvNet@Lni.wa.gov
- Phone: 360-902-5140
Looking for the Statewide Payee Registration and W-9 Form?
If you're applying online with ProviderSource, complete one of these forms for each location or tax ID you have. Download, fill out, print, and sign, then fax or mail to the address on the form.
