To request an initial application, add a facility or request additional privileges, complete the application request form, using the link below:
A Washington Practitioners Application packet or Additional membership/privileges application and privilege form(s) will be emailed directly to the email address you provide on the form.
Initial Credentialing Packet includes:
Contact Information for all new and existing credentialed providers:
If you are currently a practitioner on staff at a MultiCare Health System (MHS) entity (ies), please use the Practitioner Change Form to notify the Credentialing office of any changes to your personal contact information, specifically; legal name changes, home or office address, phone, fax, cell or beeper information that can assist us in ensuring that we have the most current and accurate information in our system to better serve you.
Note: This form can also be used as notification for Resignation from any MHS facility.
MultiCare Health System
315 Martin Luther King Jr Way
Tacoma, WA 98405
Email: [email protected]