Credentialing

Here you'll find all the documents and information you need to begin the initial credentialing process at Providence Regional Medical Center Everett. Contact Karen Anderson at 425-261-3087 if you have questions.

Return your completed forms to:
PRMCE Medical Staff Office
P.O. Box 1147
Everett  WA 98206

Instructions:

• Initial Application Instructions (.doc)
• Medical Staff Membership: General Qualifications (PDF)
• Bylaws, Rules & Regulations (PDF)
• Privilege Explanation Letter (PDF)  email Karen Anderson with your Specialty and the appropriate privileging forms will be sent back to you.

Forms to be completed and returned:

• Washington Practitioner Application (.doc)
• Signature Pages (PDF)
• Applicant's Intended Practice Plan (PDF)
• Disclosure Statement (PDF)
• Tuberculosis Symptoms Checklist (.doc) (if applicable)
  

Required reading:  Governance Documents and Policies Applying to the Medical Staff:

• Governance Documents
• Ethical and Religous Directives (PDF)
• Immunization Policy (PDF)
• Life Support Training Policy (.doc)
• Mission, Vision, and Core Values (PDF)
• PPD Testing Policy (PDF)