Professions that may prescribe prescriptions
- Advanced registered nurse practitioner (ARNP) (NP)
-
Restriction
Out-of-State Rx Accepted
(non-controlled drug from practitioner from B.C. Canada)*Yes
RCW/WAC
Comments: prescribing within the providers scope of practice.
- Osteopathic physician assistants (OA) if certified by the National Commission on Certification of Physician Assistants, may use PA-C
-
Restriction
As approved by the Board of Osteopathic Medicine and Surgery
Out-of-State Rx Accepted
(non-controlled drug from practitioner from B.C. Canada)*Yes
RCW/WAC
Comments: prescribing within the providers scope of practice.
Note: See DOH webpage for opioid prescribing requirements. - Certified registered nurse anesthetist (CRNA)
-
Restriction
Legend and Schedule II-IV for anesthesia per facility protocols
Out-of-State Rx Accepted
(non-controlled drug from practitioner from B.C. Canada)*No
RCW/WAC
Comments: prescribing within the providers scope of practice
N/A
- Dentist (DMD or DDS)
-
Restriction
None
Out-of-state Rx Accepted
(non-controlled drug from practitioner from B.C. Canada)*Yes
RCW/WAC
Comments: prescribing within the providers scope of practice
- RCW 18.32.020 and RCW 18.32.685 Practice of Dentistry
- Note: See DOH webpage for opioid prescribing requirements.
- Naturopath (naturopathic doctor or ND)
-
Restriction
Controlled substance prescription are limited to testosterone and codeine-containing substances in Schedules III-V
Out-of-State Rx Accepted
(non-controlled drug from practitioner from B.C. Canada)*No
RCW/WAC
Comments: prescribing within the providers scope of practice.
N/A
- Optometrist (OD)
-
Restriction
No oral steroids. Epinephrine by injection for anaphylactic shock. May write controlled substance prescriptions for Scheduled II hydrocodone combination products and Schedule III-V only and are limited to seven days per single condition.
Out-of-State Rx Accepted
(non-controlled drug from practitioner from B.C. Canada)*No
RCW/WAC
Comments: prescribing within the providers scope of practice.
Practitioners must meet certification requirements to receive prescriptive authority. Prescriptions must be within scope of practice and include notation of purpose.
- Osteopathic physicians (DO)
-
Restriction
None
Out-of-State Rx Accepted
(non-controlled drug from practitioner from B.C. Canada)*Yes
RCW/WAC
Comments: prescribing within the providers scope of practice.
- Pharmacist (RPh or PharmD)
-
Restriction
Initiate, modify or continue drug therapy under agreement with authorized prescriber. Agreement must be on file with the Pharmacy Quality Assurance Commission
Out-of-State Rx Accepted
(non-controlled drug from practitioner from B.C. Canada)*No
RCW/WAC
Comments: prescribing within the providers scope of practice.
May prescribe legend drugs, including controlled substances and vaccines with a collaborative agreement
- Certified physician assistant (PA- C)
-
Restriction
As approved by the Medical Commission (WMC)
Out-of-State Rx Accepted
(non-controlled drug from practitioner from B.C. Canada)*Yes
RCW/WAC
Comments: prescribing within the providers scope of practice.
None. A practice agreement must be on file with the WMC. PA and PA-C have the same prescriptive authority as the sponsoring physician. See
Note: See DOH webpage for opioid prescribing requirements. - Physician assistant (PA)
-
Restriction
As approved by the Medical Commission
Out-of-State Rx Accepted
(non-controlled drug from practitioner from B.C. Canada)*Yes
RCW/WAC
Comments: prescribing within the providers scope of practice.
May dispense medications from office supplies
- Physicians (MD)
-
Restriction
None
Out-of-State Rx Accepted
(non-controlled drug from practitioner from B.C. Canada)*Yes
RCW/WAC
Comments: prescribing within the providers scope of practice.
N/A
- Podiatric physician (DPM)
-
Restriction
None
Out-of-State Rx Accepted
(non-controlled drug from practitioner from B.C. Canada)*Yes
RCW/WAC
Comments: prescribing within the providers scope of practice.
Podiatry practice only
- Veterinarian (DVM)
-
Restriction
For animal treatment only.
Out-of-State Rx Accepted
(non-controlled drug from practitioner from B.C. Canada)*Yes
RCW/WAC
- Chapter 18.92 RCW
- WAC 246-933-110, 320, 340 and 530
- RCW 18.92.012
- RCW 18.92.013
- RCW 18.92.015
- RCW 69.50.101(ii)(1)
Comments: prescribing within the providers scope of practice.
Veterinarians may dispense limited amount of prescriptions prescribed by other veterinarians per RCW 18.92.012.
General Prescribing Limitations
- See below
-
- Providers may prescribe non-controlled substances for themselves. Although permitted, it is not recommended that they prescribe controlled or non-controlled substances for family members without a provider/patient relationship.
- Prescriptions written by MDs, DOs, DDSs, DPMs, DMDs, DVMs, ARNPs and physician assistants from out-of-state may be dispensed. It's not permitted for other out-of-state prescribers per RCW 69.41.030 and RCW 69.50.101(40)(c).
- Prescriptions written by MDs, DOs, DDSs, DPMs, DMDs, DVMs, ARNPs and physician assistants from British Columbia may be dispensed; except controlled substances because they're not DEA registrants.
- Prescriptions must be for a legitimate medical purpose.
- There must be a valid “provider, patient, client” relationship.
- Drugs must be within the provider's scope of practice.
- Prescriptions written in Washington for delivery to the pharmacy must be on Pharmacy Quality Assurance Commission approved tamper-resistant prescription paper per RCW18.64.500.
- Prescriptions written in Washington must have two signature lines at opposite ends on the bottom of the form. "DISPENSE AS WRITTEN" on the right and "SUBSTITUTION PERMITTED" on the left.
- Health care providers with prescriptive authority may prescribe epinephrine autoinjectors in the name of an authorized entity according to RCW 70.54.440. Pharmacists, ARNPs and physicians (MD and DO) may dispense epinephrine autoinjectors for a prescription issued in the name of an authorized entity.
- As of June 2023, practitioners with a current Drug Enforcement Agency (DEA) registration that includes Schedule III authority may prescribe medications, such as buprenorphine, for the treatment of opioid use disorder if permitted by state law. Information on Qualifications.
Professions that may administer drugs ordered by authorized prescribers
- See below
-
Profession Authorization Acupuncturist and Eastern medicine practitioners (RCW 18.06.010) Point injection therapy includes injection of sterile water, minerals and vitamins in liquid form. Point injection therapy does not include injection of controlled substances contained in Schedules I through V of the uniform controlled substances act, chapter 69.50 RCW or steroids as defined in RCW 69.41.300. Athletic trainer (RCW 18.250.110) An athletic trainer may purchase, store, and administer over-the-counter medications as prescribed by an authorized health care practitioner for the practice of athletic training.
An athletic trainer who has completed accredited training programs on pharmacology and medication administration may purchase, store, and administer medications in accordance with the programs, as prescribed by an authorized health care practitioner for the practice of athletic training.
Cardiovascular invasive specialist (chapter18.84 RCW) Administer diagnostic and therapeutic agents during cardiac or vascular catheterization procedures under the personal supervision of a physician. Dental anesthesia assistant, certified (RCW 18.350.040) -- Dental assistant, registered (RCW 18.260.040) -- Dental hygienist (chapter 18.29 RCW) Local anesthetics, topical fluoride and antimicrobials for dental patients only. Emergency medical technician (EMT) (RCW 18.73.081) Administration of prescribed drugs within scope of practice per verbal or written orders of MD or DO also credentialed as a county medical program director (MPD) or MPD delegate. Expanded function dental auxiliary (EFDA) (RCW 18.260.070) Home care aides (RCW 18.88B) May administer in community-based care settings or in-home care settings under nurse delegation. Intermediate life support technician (ILS) (RCW 18.71.205) Administration of prescribed drugs within scope of practice per verbal or written orders of MD or DO also credentialed as a county medical program director (MPD) or MPD delegate. Licensed midwife (RCW 18.50.115, WAC 246-834-250) Purchase and administer certain drugs. May also administer drugs that have been prescribed by a physician. Licensed practical nurse (LPN) (chapter 18.79 RCW, WAC 246-840) Administer prescribed drugs within, scope of practice, under the general direction of an ARNP, MD, DO, DPM, DDS, PA or ND, and under the direction or supervision of a registered nurse.
- Standing Orders and Verbal Orders (NCAO 6.0 (PDF)
- Dispensing Medications/Devices for Prophylactic and Therapeutic Treatment of Communicable Diseases and Reproductive Health by Public Health Nurses NCAO 9.0 (PDF)
Medical assistant (MA) - certified, MA-registered and MA-hemodialysis technician (chapter RCW 18.360, WAC 246-827) Administer prescribed drugs within scope of practice (see RCW 18.360.050) and under the supervision of a healthcare practitioner as defined in RCW 18.360.010(3). MA-hemodialysis technician may administer oxygen and drugs necessary for hemodialysis (see WAC 246-827-0500 and WAC 246-827-0520). MA-registered may administer eye drops, topical ointments and vaccines, including combination or multidose vaccines. See WAC 246-827-0240 for MA-certified. Nursing assistant (CNA or NAR) (chapter 18.88A RCW) May administer in community-based care settings or in-home care settings under nurse delegation. CNA may administer in a nursing home setting with a medication assistant endorsement. Nursing technician (NT) (chapter 18.79 RCW, WAC 246-840 Must be enrolled in a commission-approved nursing program and meet other requirements may administer medications within the limits of their education, skills and knowledge under the direct supervision of a RN. The NT may not administer chemotherapy drugs, intravenous medications, or scheduled drugs (see chapter RCW 18.79.350 and WAC 246-840-870). Occupational therapist (RCW 18.59.040, chapter 246-847 WAC) May purchase, store and administer certain topical drugs as prescribed by an authorized healthcare practitioner. Paramedic (RCW 18.71.205) Administration of prescribed drugs within scope of practice per verbal or written orders of MD or DO also credentialed as a county medical program director (MPD) or MPD delegate Pharmacist (RPh or PharmD) (chapter 18.64 RCW) Administer prescribed drugs. Pharmacy technician (RCW 18.64A.010(6), RCW 18.64A.030, RCW 18.64A.060, RCW 18.64.011) May provide administration of medications or devices under the immediate supervision of a pharmacist and if the Pharmacy Quality Assurance Commission has authorized the pharmacy technician to administer medications or devices by approving an ancillary personnel utilization plan (AUP). Physical therapists (PT) (chapter 18.74 RCW) May purchase, store and administer certain drugs as determined by law and may administer such other drugs or medications as prescribed by an authorized healthcare practitioner for the practice of physical therapy. Radiologic technologist (chapter 18.84 RCW) Administer diagnostic and therapeutic agents under the direct supervision of a physician. Radiologist assistant (chapter 18.84 RCW) Administer imaging and non-imaging agents parenterally, administer oral medications; level of supervision specified in regulation (WAC 246-926-300). Registered nurse (RN) (chapter 18.79 RCW, WAC 246-840) Administer prescribed drugs within, scope of practice, under the general direction of an ARNP, MD, DO, DPM, DDS, PA or ND, and under the direction or supervision of a registered nurse. Respiratory care practitioner chapter (18.89 RCW) Administer prescribed drugs for the practice of respiratory care as defined by statute. School personnel (RCW 28A.210.260 thru 280) Superintendent of Public Instruction – Health Services Veterinary technician (RCW 18.92.013, WAC 246-935-410 thru 440) May administer prescribed drugs with indirect supervision of a veterinarian
Examples of professions that may not prescribe, administer or dispense drugs
- See below
-
Profession Authorizing Statute Animal massage therapist Chapter 18.240 RCW Chiropractor and chiropractic x-ray technician Chapter 18.25 RCW Counselor, licensed marriage and family therapist and licensed marriage and family therapist associate Chapter 18.225 RCW Counselor, licensed mental health counselor and licensed mental health counselor associate Chapter 18.225 RCW Counselor, certified counselor, certified adviser, agency affiliated counselor and hypnotherapist Chapter 18.19 RCW Counselor, licensed social worker advanced, licensed social work associate advanced, Licensed social work independent clinical, and licensed social work associate independent clinical Chapter 18.225 RCW Denturist Chapter 18.30 RCW Dietitian and nutritionist Chapter 18.138 RCW Doula Chapter 18.47 RCW Genetic counselor Chapter 18.290 RCW Massage therapist Chapter 18.108 RCW Ocularist Chapter 18.55 RCW Optician Chapter 18.34 RCW Optician apprentice RCW 18.34.030 Orthotist and prosthetist Chapter 18.200 RCW Pharmacy technician Chapter 18.64A RCW (may assist pharmacist) Psychologist Chapter 18.83 RCW Recreational therapist Chapter 18.230 RCW Sex offender treatment provider and affiliate provider Chapter 18.155 RCW Substance use disorder professionals and substance use disorder professional trainee Chapter 18.205 RCW Surgical technologist Chapter 18.215 RCW Veterinary medication clerk RCW 18.92.030 and 125 (may assist veterinarian) X-Ray technician Chapter 18.84 RCW