Prevent delays in authorization and payment by maintaining your information. Please report changes to your account within 14 calendar days.
| How to update your account with L&I | ||
| If you are a: | And your tax id (EIN) changes: | And your address or business status changes: |
| Network provider |
|
Notify us using the Provider Change Form. |
| Non-network provider | Update your Provider Account Application and submit your new W-9 form (combined). |
|
| IME Provider |
|
Notify us using the Approved IME Examiner Update form. |
Send change request to:
Fax: 360-902-4563
Mail:
Provider Credentialing & Compliance
PO Box 44621
Olympia WA 98504-4161
Verify your account listing in Find a Doctor to ensure injured workers and other providers can find you.
