First Health Request
Please complete this form if you'd only like to join our First Health network. If you'd like to join both Aetna and First Health, you should apply using only the Aetna Medical Request for Participation form.
Go to the Aetna Medical Request for Participation form
If you already work with us and need to update your Tax ID (TIN), don’t use this form. Instead, log in to Availity or the electronic transaction vendor that you use.
If you need more information about our application and credentialing process, use the link below. You also will find information on the Council for Affordable Quality Healthcare's (CAQH's) ProView® and ProviderSource™ (for Washington State licensed practitioners).
Information about application and credentialing process
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.