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Ress. (This cannot be a PO Box). 6. Enter the billing address where we mail your payments as it appears on your bills submitted to the Department of Labor & Industries. 7. Enter the business location appointment phone number. (The number to call to make an appointment). 8. Enter the billing contact person s phone number. (The person who can answer questions regarding your bills). C. Individual Provider 9. Enter the name of the individual or organization providing services. 10. Enter the ty.

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