50-State Guide
Washington
Last updated June 2026
At a Glance
| Category | Details |
|---|---|
| IMLC Member | Yes |
| FCVS | Accepted |
| NP Independent Practice | Yes |
| PA Independent Practice | Yes |
| Physician-Owned PC Allowed | No |
| Max NPs per Physician | No Limit (FPA) |
| Max PAs per Physician | No Limit |
Licensure
| Item | Cost |
|---|---|
| Initial License | $491 |
| Renewal Fee | $996 |
| Renewal Cycle | Biennial |
| Annualized Cost | $498.00 |
| Controlled Substance Registration | No |
In-State Physician Requirement
None.
APC Supervision
Nurse Practitioners
NPs can practice independently in Washington.
- Maximum NPs per physician: No Limit (FPA)
Physician Assistants
PAs can practice independently in Washington.
- Maximum PAs per physician: No Limit
CME & Training Requirements
| Requirement | Details |
|---|---|
| Total CME | 50 hours |
| Category 1 Minimum | See board |
| Cycle | 4-year |
| Opioid/Pain Mgmt | Not required |
| Human Trafficking | Not required |
| Implicit Bias | Not required |
| Suicide Prevention | Required |
| DEA MATE Act | 8 hrs one-time (federal) |
| Jurisprudence Exam | Required |
Fingerprint Requirements
| Detail | Info |
|---|---|
| Required | Yes |
| FBI Check | Yes |
| Method | Ink cards (FD-258) |
| Out-of-State Options | Contact board |
| Timing | After application submitted |
Quirks & Gotchas
- Applications go through HELMS (the WMC online portal). A “Payment PIN” system was recently introduced for bulk fee payments — worth confirming you are using the current portal workflow.
- The commission can demand “such additional information as it deems necessary” with no upper bound defined in statute (RCW 18.71.050). This is vague by design and gives WMC broad discretion to require supplemental documentation.
- If you previously had malpractice suits (resolved or pending), pending licensing actions in other states, hospital privilege issues, or a gap of 2+ years without active practice, the commission may require you to take the SPEX (Special Purpose Examination) — passing score of 75. This is not disclosed prominently upfront but is a real gotcha for returning-to-practice physicians (WAC 246-919-370).
- Out-of-state temporary permits are hard 90-day, no-renewal, no-extension. If you do not finish your full application within 90 days, you must stop practicing. There is no second permit (WAC 246-919-395).
- An FBI fingerprint card (physical card) must be submitted to the Department of Health — not a digital scan service. This is an older-style requirement that can add significant time.
- A temporary permit is issued while the national background check processes, valid for 6 months with one possible 6-month extension only. If the federal report is still not back after 12 months, no further extensions are available (WAC 246-919-396).
- No Washington-specific jurisprudence exam is codified in WAC 246-919. This is notable — many states require one. WMC does not appear to mandate it as of current rules. However, WMC retains broad discretion under “additional information” authority, so confirm with the commission directly that none is required at time of application.
- Initial application: $511 total ($425 base + $16 UW HEAL-WA surcharge + $70 physician health program surcharge).
- Active 2-year renewal: $996 total ($824 + $32 + $140). This is among the highest renewal fees in the country.
- The $70/$140 physician health program (Washington Physicians Health Program) surcharge is mandatory for everyone regardless of whether you ever use the program. It is not optional and is not disclosed as a separate “fee” in plain-language summaries.
- The $16/$32 UW HEAL-WA surcharge is similarly buried.
- Late renewal penalty: $300 for active licenses.
- Verification of license (for credentialing): $50 per request — this can add up during hospital privilege applications at multiple facilities.
- Temporary practice permit: $50, on top of the application fee.
- Transition from postgraduate to active license: $186 additional.
- 200 hours of CME every 4 years (WAC 246-919-430). The cycle is tied to license renewal.
- No mandatory topic categories are codified in WAC 246-919 itself. The CME categories (I–V) are format-based, not content-based.
- However**, there are two mandatory training requirements layered on top of the CME total via WAC 246-12:
- Suicide Prevention Training** (WAC 246-12-630): A 6-hour or 3-hour structured training with specific content minimums (90 min suicide assessment, 60 min treatment/management, 30 min veteran populations, 30 min lethal means/imminent harm). Timing/frequency is not clearly specified in the WAC text, creating ambiguity about when it must first be completed and whether it repeats.
- Health Equity CE** (WAC 246-12-820): Minimum 2 hours every 4 years. Individual boards can require more. Content is flexible but must address the defined “health equity” framework.
Researched from state board websites and regulatory sources. Verify with the board directly before applying.
Resources
Sources
Data compiled from state medical board websites, FSMB, and regulatory filings. Last updated June 2026.
Have a correction or update? Let us know.