Protocol · NP · Washington
Practice Protocol for Nurse Practitioners in Washington
Nurse Practitioners practice independently in Washington. A practice protocol is voluntary; here is what one covers and what the state does require.
Washington is a longstanding full-practice-authority state — ARNPs (which includes NP) are licensed independent practitioners under RCW 18.79 with no physician agreement of any kind required, verified current for 2026 against WAC 246-840-300.
What a voluntary Nurse Practitioner protocol covers in Washington
Washington requires no written protocol for nurse practitioners. These are the clauses a practice includes when it chooses to put one in writing. The Washington State Board of Nursing and the Washington State Pharmacy Quality Assurance Commission governs nurse practitioners here.
Washington does not require the Nurse Practitioner to enter into a collaboration or supervision agreement with a physician, and no minimum-hours transition period applies. The Nurse Practitioner practices, diagnoses, and prescribes, including Schedule II through V controlled substances with a DEA registration, under the Nurse Practitioner's own license, consistent with RCW 18.79.250 and WAC 246-840-300.
This Agreement's terms regarding the Nurse Practitioner accordingly serve to define the working relationship, referral pathways, and any Medical Director oversight between the Parties, and are not themselves required by Washington law as a condition of the Nurse Practitioner's authority to practice.
- A voluntary protocol also carries 1 scope, 1 education and 1 registration clauses, authored in the document itself.
What Washington does require
The supervision and prescribing rules that apply to nurse practitioners regardless of any protocol.
Proximity
No proximity requirement
No physician-oversight relationship exists — ARNPs are licensed independent practitioners under WAC 246-840-300.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified
Meeting cadence
Not codified
Prescriptive authority
No agreement needed to prescribe · controlled substances permitted
Schedule II-V upon Board of Nursing prescriptive-authority approval (RCW 18.79.240); Schedule I remains off-limits by statute. Requires an additional 15 hours/2-year-cycle of pharmacotherapeutics CE beyond the base 30-hour ARNP CE requirement.
Written agreement
Not required
Unconditional — no collaborating-physician agreement of any kind is required for ARNP/NP licensure or practice in Washington.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional Service Corporation under RCW 18.100.050 — NPs are one of 12 enumerated health professions eligible to co-own a multi-discipline PSC (alone or with physicians/PAs/other listed professions); non-licensees may not hold equity.
Sources for the supervision rules (3)
About Washington's rules
Washington is a full-independence state for ALL FOUR ARNP roles (NP, CRNA, CNM, CNS) under RCW 18.79, not just NPs — confirmed current via WAC 246-840-300/420 and Board of Nursing guidance. PAs are separate: HB 2041 (eff. Jan. 1, 2025) replaced supervision-only with a 4,000-hour supervision→collaboration tier (RCW 18.71A.120) with no numeric ratio cap.
Other clinicians in Washington: see the state overview.