Who Can Prescribe and Administer Prescriptions in Washington State

 

Professions that can prescribe drugs

Professions that may administer drugs ordered by authorized prescribers

Examples of professions that may not prescribe, administer or dispense drugs


Professions that can prescribe drugs

Profession Restriction Out-of-State Rx Accepted
(non-controlled drug from practitioner from B.C. Canada)*
RCW/WAC Comments: prescribing within the providers scope of practice.
Advanced registered nurse practitioner (ARNP) (NP) None

Yes

RCW 69.50.101(jj)(3)
RCW 69.41.030*

RCW 18.79.250
RCW 69.41.030
RCW
69.50.101(ii)(1) WAC 246-840-400 thru 420
Note: See DOH webpage for opioid prescribing requirements.
Osteopathic physician assistants (OA) if certified by the National Commission on Certification of Physician Assistants, may use PA-C As approved by the Board of Osteopathic Medicine and Surgery

Yes

RCW 69.50.101(jj)(3)
RCW 69.41.030*

Chapter 18.57A RCW
WAC 246-854-030
Chapter 18.57
RCW
RCW 69.41.030
RCW 69.50.101 (ii) (1)

Note: See DOH webpage for opioid prescribing requirements.
Certified registered nurse anesthetist (CRNA) Legend and Schedule II-IV for anesthesia per facility protocols No RCW 18.79.240(r)
RCW 69.41.030
RCW
69.50.101(ii)(1)
 
Dentist (DMD or DDS) None

Yes

RCW 69.50.101(jj)(3)
RCW 69.41.030*

Chapter 18.32
RCW
RCW 69.41.030
RCW
69.50.101(ii)(1)
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) Controlled substance prescription are limited to testosterone and codeine-containing substances in Schedules III-V No Chapter 18.36A
RCW WAC 246-
836-210
RCW 69.50.101(jj)(1)
 
Optometrist (OD) 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. No Chapter 18.53 RCW
WAC 246--851-580
WAC 246-851-590
RCW 69.50.101(jj)(1)

Practitioners must meet certification requirements to receive prescriptive authority. Prescriptions must be within scope of practice and include notation of purpose.

Osteopathic physicians (DO) None

Yes

RCW 69.50.101(jj)(3)
RCW 69.41.030*

Chapter 18.57 RCW
RCW 69.41.030
RCW 69.50.101(ii)(1)
Note: See DOH webpage for opioid prescribing requirements.
Pharmacist (RPh or PharmD) Initiate, modify or continue drug therapy under agreement with authorized prescriber. Agreement must be on file with the Pharmacy Quality Assurance Commission No RCW 18.64.011(11) WAC 246-863-100
RCW 69.50.101(ii)(1)
May prescribe legend drugs, including controlled substances and vaccines with a collaborative agreement
Certified physician assistant (PA- C) As approved by the Medical Commission (WMC)

Yes

RCW 69.50.101(jj)(3)
RCW 69.41.030*

Chapter 18.71A RCW
WAC 246-918-035
RCW 69.41.030
RCW 69.50.101 (ii) (1)
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) As approved by the Medical Commission

Yes

RCW 69.50.101(jj)(3)
RCW 69.41.030*

Chapter 18.71A RCW
RCW 69.41.030
WAC 246-918-035
RCW 69.50.101(ii)(1)

May dispense medications from office supplies
Physicians (MD) None

Yes

RCW 69.50.101(jj)(3)
RCW 69.41.030*

 

Chapter 18.71 RCW
RCW 69.41.030
RCW 69.50.101(ii)(1)
 
Podiatric physician (DPM) None

Yes

RCW 69.50.101(jj)(3)
RCW 69.41.030*

Chapter 18.22 RCW
RCW 69.41.030
RCW 69.50.101(ii)(1)
Podiatry practice only
Veterinarian (DVM) For animal treatment only.

Yes

RCW 69.50.101(jj)(3)
RCW 69.41.030*

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)

Veterinarians may dispense limited amount of prescriptions prescribed by other veterinarians per RCW 18.92.012.

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General Prescribing Limitations

  1. 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.
  2. 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(w)(3).
  3. 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.
  4. Prescriptions must be for a legitimate medical purpose.
  5. There must be a valid “provider, patient, client” relationship.
  6. Drugs must be within the provider's scope of practice.
  7. 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.
  8. 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.
  9. 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 physician (MD and DO) may dispense epinephrine autoinjectors for a prescription issued in the name of an authorized entity.
  10. Expands prescribing privileges to NPs, and PAs who have completed training may be eligible for a waiver to prescribe buprenorphine for opioid dependency treatment. Previously restricted to MDs and DOs. Waiver Information.

Professions that may administer drugs ordered by authorized prescribers

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) Administer over-the-counter topical medications such as hydrocortisone, fluocinonide, topical anesthetics, silver sulfadiazine, lidocaine, magnesium sulfate, zinc oxide, and other similar medications, 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 Mediations/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.
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.
  • Standing Orders and Verbal Orders NCAO 6.0 (PDF).
  • Dispensing Mediations/Devices for Prophylactic and Therapeutic Treatment of Communicable Diseases and Reproductive Health by Public Health Nurses NCAO 9.0 (PDF).
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.

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Examples of professions that may not prescribe, administer or dispense drugs

Profession Authorizing Statute
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
Genetic counselor Chapter 18.290 RCW
Massage practitioner Chapter 18.108 RCW
Ocularist Chapter 18.55 RCW
Optician Chapter 18.34 RCW
Orthotist and prosthetist Chapter 18.200 RCW
Pharmacy technician Chapter 18.64A RCW (may assist pharmacist)
Psychologist Chapter 18.83 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

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