Laserfiche WebLink
HEALTH PLAN: <br />Coordinated Care of Washington, Inc. <br />Authorized Signature: <br />Print Name: Beth Johnson <br />Title: Plan President & CEO <br />Signature Date: <br />ICM #: ICMProviderAgreement_360268 <br />To be completed by Health Plan only: <br />Effective Date: <br />PPA WA - Kittitas County Public Health - 05.07.2025 - ICMProviderAgreement_360268 Page 18 of 24 <br />