Who May Prescribe and Administer Prescriptions in Washington State

Professions Who May Prescribe

Advanced Registered Nurse Practitioner (ARNP or NP)

Profession's RCW/WACs:

Restriction: None

Out-of-State Prescriptions Accepted: Yes, RCW 69.41.030, RCW 69.50.101(40)

Canadian Noncontrolled Prescriptions Accepted: Yes, RCW 69.41.030

Notes: Profession must prescribe within the provider’s scope of practice. See DOH webpage for opioid prescribing requirements.

Certified Registered Nurse Anesthetist (CRNA)

Profession's RCW/WACs:

Restriction: Legend and Schedule II-IV for anesthesia per facility protocols

Out-of-State Prescriptions Accepted: No

Canadian Noncontrolled Prescription Accepted: No

Notes: Profession must prescribe within the provider’s scope of practice.

Dentist (DMD or DDS)

Profession's RCW/WACs:

Restriction: None

Out-of-state Prescriptions Accepted: Yes, RCW 69.41.030, RCW 69.50.101(40)

Canadian Noncontrolled Prescriptions Accepted: Yes, RCW 69.41.030

Notes: Profession must prescribe within the provider’s scope of practice. See DOH webpage for opioid prescribing requirements.

Licensed Midwife

Profession’s RCW/WACs:

Restriction: No controlled substance prescriptions

Out-of-State Prescriptions Accepted: No

Canadian Noncontrolled Prescriptions Accepted: No

Notes: Profession must prescribe within the provider’s scope of practice. Practitioners must meet license extension requirements to receive limited prescriptive authority. Prescriptions must be within scope of practice and include notation of purpose.

Naturopath Physician (ND)

Profession's RCW/WACs:

Restriction: Controlled substance prescriptions are limited to testosterone and codeine-containing substances in Schedules III-V

Out-of-State Prescriptions Accepted: No

Canadian Noncontrolled Prescriptions Accepted: No

Notes: Profession must prescribe within the provider’s scope of practice.

Optometrist (OD)

Profession's RCW/WACs:

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 Prescriptions Accepted: No

Canadian Noncontrolled Prescriptions Accepted: No

Notes: Profession must prescribe within the provider’s scope of practice and include notation of purpose. Practitioners must meet certification requirements to receive prescriptive authority.

Osteopathic Physician (DO)

Profession's RCW/WACs:

Restriction: None

Out-of-State Prescriptions Accepted: Yes, RCW 69.41.030, RCW 69.50.101(40)

Canadian Noncontrolled Prescriptions Accepted: Yes, RCW 69.41.030

Notes: Profession must prescribe within the provider’s scope of practice. See DOH webpage for opioid prescribing requirements.

Osteopathic Physician Assistant (OA)

Profession's RCW/WACs:

Restriction: As approved by the Board of Osteopathic Medicine and Surgery

Out-of-State Prescriptions Accepted: Yes, RCW 69.41.030, RCW 69.50.101(40)

Canadian Noncontrolled Prescriptions Accepted: Yes, RCW 69.41.030

Notes: Profession must prescribe within the provider’s scope of practice. See DOH webpage for opioid prescribing requirements.

Pharmacist (RPh or PharmD)

Profession's RCW/WACs:

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 Prescriptions Accepted: No

Canadian Noncontrolled Prescriptions Accepted: No

Notes: Profession must prescribe within the provider’s scope of practice. See DOH webpage for opioid prescribing requirements.

Physician (MD)

Profession's RCW/WACs:

Restriction: None

Out-of-State Prescriptions Accepted: Yes, RCW 69.41.030, RCW 69.50.101(40)(c)

Canadian Noncontrolled Prescriptions Accepted: No

Notes: Profession must prescribe within the provider’s scope of practice.

Physician Assistant

Profession's RCW/WACs:

Restriction: As approved by the Medical Commission

Out-of-State Prescriptions Accepted: Yes, RCW 69.41.030, RCW 69.50.101(40)(c)

Canadian Noncontrolled Prescriptions Accepted: Yes, RCW 69.41.030

Notes: Profession must prescribe within the provider’s scope of practice. See DOH webpage for opioid prescribing requirements.

Physician Assistant, Certified (PA-C)

Profession's RCW/WACs:

Restriction: As approved by the Medical Commission

Out-of-State Prescriptions Accepted: Yes, RCW 69.41.030, RCW 69.50.101(40)(c)

Canadian Noncontrolled Prescriptions Accepted: Yes, RCW 69.41.030

Notes: Profession must prescribe within the provider’s scope of practice. See DOH webpage for opioid prescribing requirements.

Podiatric Physician (DPM)

Profession's RCW/WACs:

Restriction: None

Out-of-State Prescriptions Accepted: Yes, RCW 69.41.030, RCW 69.50.101(40)(c)

Canadian Noncontrolled Prescriptions Accepted: Yes, RCW 69.41.030

Notes: Profession must prescribe within the provider’s scope of practice.

Veterinarian (DVM)

Profession's RCW/WACs:

Restriction: For animal treatment only.

Out-of-State Prescriptions Accepted: Yes, RCW 69.41.030, RCW 69.50.101(40)(c)

Canadian Noncontrolled Prescriptions Accepted: Yes, RCW 69.41.030

Notes: Profession must prescribe within the provider’s 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 noncontrolled substances for themselves. Although permitted, it is not recommended that they prescribe controlled or noncontrolled 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 is 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 are 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 Prescriptions Ordered by Authorized Providers

See below:

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) – May purchase, store, and administer over-the-counter 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 (chapter 18.88B RCW) – 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 Practical Nurse (LPN) (chapter 18.79 RCW, chapter 246-840 WAC) – 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 18.360 RCW, chapter 246-827 WAC) – 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, chapter 246-840 WAC) – 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 18.79.350 RCW and WAC 246-840-870).

Occupational Therapist (chapter 246-847 WAC, RCW 18.59.040) – 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 18.74.160 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, chapter 246-840 WAC) – 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 prescriptions

See below

Animal Massage Therapist – Chapter 18.240 RCW

Birth Doulas – Chapter 18.47 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

Genetic Counselor – Chapter 18.290 RCW

Massage Practitioner – 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