Wa license verification
[DOCX File]STATE OF WASHINGTON
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AUTHORIZATION FOR VERIFICATION – COMPANY. TO WHOM IT MAY CONCERN: I, the undersigned official of the company noted above hereby authorize and request you to provide the Department of Financial Institutions of the State of Washington, any and all information and documentation they request for the purpose of verifying information provided in conjunction with an …
[DOCX File]Consent to Verify Eligibility and Bill for School-Based ...
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Form 12b - Medicaid Consent for Verification and BillingMarch 2013 (Rev. 8/2018) PURPOSE: This form asks for your consent to share necessary information to verify Medicaid eligibility and to bill for school-based Medicaid reimbursement with the Washington State Health Care Authority (HCA).
[DOCX File]General Self-Inspection Worksheet (February 2021) - Wa
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Read this Page Carefully. WA Pharmacy Quality Assurance Commission. 2021 . General. Pharmacy. Self-Inspection. Worksheet. Attention: Responsible Pharmacy Manager (or Equivalent Manager) Washington law holds the responsible pharmacy manager (or equivalent manager) and all pharmacists on duty responsible for ensuring pharmacy compliance with all state and federal laws governing the …
[DOCX File]Adult Family Home License Application
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Adult Family Home License Application. ADULT FAMILY HOME LICENSE APPLICATION. Page 1 of 6. DSHS 10-410 (REV. 0. 9 /2018) ADULT FAMILY HOME LICSENE APPLICATION. DSHS 10-410 (REV.
[DOC File]Cover letter – Initial License or Initial License ... - Wa
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A copy of the applicant’s Master License Service Registrations and Licenses (business license), the Certificate of Incorporation or Certificate of Formation issued by the Secretary of State, or any other official document issued by any State of Washington agency will be accepted as verification …
[DOCX File]School-Age Child Care Center - Wa
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$125 non-refundable license fee. After DCYF determines the facility’s capacity AND prior to the initial license being issued, the remaining license fee must be paid in full. The license fee for a school-age child care center is $125 for the first twelve children plus $12 for each additional child over the licensed capacity of twelve children.
[DOCX File]www.dcyf.wa.gov
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The information that I share with DCYF is subject to verification by federal and state officials. NOTE: Pursuant to RCW 43.216.260(2), the department may deny, revoke, or suspend your license if you try to, or do, receive a license through deceitful means, fraud, or material omissions because it shows a lack of character, suitability, and ...
[DOC File]Citizenship and Identity Documents - Tier 1-4 - Wa
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Citizenship and Identity Verification Documents – T1 – T4. T1 Documents (Only Tier 1 documents are considered by the federal government to document both citizenship and identity). US Passport. Enhanced Drivers license or state ID (only if issuing state verifies citizenship to issue enhanced document) Certificate of Naturalization.
Mass.gov
: Please complete the waiver for release of information and forward this form to your university/medical school(s) or university of graduation for verification. Please note : Fourth year medical students must include the letter to the medical school registrar and Form B
Provider Credential Search and License Verification ...
This site is a primary source for verification of credentials. News releases about disciplinary actions taken against Washington State healthcare providers, agencies or facilities are on the agency's Newsroom webpage .
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