Provider network participating request form
Interested in joining our provider network? Please complete and submit the new provider network participation request form below.
If you have not already reviewed our nominations panel, please do so before submitting the new provider network participation request form.
Check the panel now
| Nominations Panel - Oregon | ||
|---|---|---|
| County | Specialties | |
|
Clackamas |
Primary Care: Open |
|
|
Benton |
Primary Care: Open |
|
|
Columbia |
Primary Care: Open |
|
|
Baker |
Primary Care: Open |
|
| Nominations Panel - Washington | ||
|---|---|---|
| County | Specialties | |
|
Benton |
Primary Care: Open |
|
| Nominations Panel - Idaho | ||
|---|---|---|
| County | Specialties | |
|
Ada |
Primary Care: Open |
|
*The nominations panel was updated in September 2021 and will be reviewed on an annual basis.
New provider network participation request form
We will review your information and contact you within 60 days of your submission.
You can also submit a print version of this new provider network participation request form. to ProviderNominations@modahealth.com or by fax at ATTN: Provider Nominations 503-243-2964.
Questions?
If you can't find an answer, please feel free to contact our Customer Service Customer Service Customer Service
Questions?
If you can't find an answer, please feel free to contact our Customer Service
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Hello.
We have exciting news to share. ODS is changing its name to Moda Health.
Moda comes from the latin term "modus" and means "a way". We picked it because that's what we are here to do: help our communities find a way to better health.
Together, we can be more, be better.
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