DSHS Form 10-664 New or Update Provider Information Worksheet - Washington

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DSHS Form 10-664 New or Update Provider Information Worksheet - Washington

What Is DSHS Form 10-664?

This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DSHS Form 10-664?
A: DSHS Form 10-664 is the New or Update Provider Information Worksheet in Washington.

Q: Who needs to complete DSHS Form 10-664?
A: Providers in Washington state who need to update or provide new information.

Q: What information is required on the form?
A: The form requires information such as provider identification, contact details, service types, and payment information.

Q: Is the form mandatory?
A: Yes, providers in Washington state are required to complete DSHS Form 10-664 to update or provide new information.

Q: How often do I need to submit the form?
A: The frequency of form submission depends on the specific requirements of the DSHS program. It is best to check with the program for their specific guidelines.

Q: Are there any fees associated with the form?
A: There are no fees associated with submitting DSHS Form 10-664.

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Form Details:

  • Released on November 1, 2020;
  • The latest edition provided by the Washington State Department of Social and Health Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of DSHS Form 10-664 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.

Download DSHS Form 10-664 New or Update Provider Information Worksheet - Washington

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