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Get WA HCA 13-967 2018-2024

Ent Date of birth Pharmacy name Pharmacy NPI (if known) Telephone number Fax number Prescriber Prescriber NPI Telephone number Fax number Medication and strength ProviderOne ID Directions for use (if known) Use of any opioid for more than 42 days within a 90 day period is considered chronic use. Use of opioids for more than 42 days may be authorized in 12 month intervals when the prescriber signs the attestation below. If a prescriber wants an attestation to be authorized for less t.

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