Medical Commission Contact Information Change Form
This survey is closed. Thank you for your interest.
For assistance filling out this form, please contact the Medical Commission Credentialing Unit at 360-236-2750.
For faster service, press ‘Email’ to electronically submit this form to the Medical Commission.
The completed form can be printed and mailed or faxed to:
Washington State Medical Commission
Credentialing Unit
P.O. Box 47866
Olympia WA 98504-7866
Fax: 360-236-2795
Medical.Commission@doh.wa.gov
DOH 658-023 July 2013