Assisted Living Facility Applications

Please ensure you are using the current Assisted Living Facility (ALF) License Application (DSHS 10-591.  Effective February 1, 2018 applications received with a revision date other than 12/2017 in the bottom left hand corner will be rejected.

The following are needed prior to applying for a license and/or contract:

Federal Employer Identification Number (EIN) - A copy of the IRS SS-4 form showing the assigned EIN number will be accepted as verification an EIN was obtained. For more information on EINs, visit

Unified Business Identifier (UBI) - A copy of the Washington State business license showing that the trade name has been registered with the Department of Revenue. For more information on UBIs, visit

Certificate of Incorporation or Certificate of Formation issued by the Secretary of State.  For more information on this registration, visit