You must send us:

1. (1) A completed provider application and Form W-9;
2. (2) A legible copy of your license, certification and/or registration;
3. (3) Ph.D.s not licensed as psychologists and master level counselors must provide a legible copy of their degree.

[Statutory Authority: RCW 7.68.030, 7.68.080. WSR 00-03-056, § 296-31-035, filed 1/14/00, effective 2/14/00.]