Please complete this form if you are interested in joining the Aetna's network.
If you need more information about our application and credentialing process, use the link below. You will also find information on the Council for Affordable Quality Healthcare's (CAQH's) Universal Provider Datasource® and ProviderSource™ (for Washington State licensed practitioners).
As a practitioner, you have the right to correct any information obtained during the credentialing process by working directly with the reporting entities.
All fields marked with a RED asterisk (*) are required.