Physical Therapist and Physical Therapist Assistant - Frequently Asked Questions

Application and Renewal | Continuing Education | License Status | Supervision | Intramuscular Needling Endorsement

Application and Renewal

How much is the application fee?

The application fee depends on the application type. You can find more information on the physical therapy licensing information webpage.

Review WAC 246-915-990 and WAC 246-915-99005 for details. 

How long does the application process take?

See the most current application processing times on our Application Status webpage. The quickest way to check the status of your application at any time is to visit the Provider Credential Search site. 

If I hold a license in another state, can I qualify for a license through endorsement?

Effective January 1, 2026, there are two pathways to apply for a license by endorsement for physical therapists and physical therapist assistants:

• Endorsement pathway for applicants licensed for two years or more in another substantially equivalent state or states: 
  
  Under WAC 246-915-040, applicants who hold a license in another state or states that the board has deemed substantially equivalent to our own, and who have no gaps in licensure lasting longer than 90 days, and no disciplinary action against their license are eligible for licensure under our endorsement pathway, and will not need to submit NPTE test scores or transcripts. 
  
  To apply, applicants must submit the following: 
   
  • Complete application and application fee
  • Verification of license(s) sent directly from the other jurisdiction(s) to the department
     
• Endorsement pathway for applicants licensed under two years in another substantially equivalent state or states: 
  
  Under WAC 246-915-040, applicants who have held a license for less than two years in another state or states that the board has deemed substantially equivalent to our own,  who have no gaps in licensure lasting longer than 90 days, have no disciplinary action against their license, including denial or conditioning of their license, and no pending investigation may be eligible for licensure under our endorsement pathway. They will need to have at least 200 working hours in the past two years in the state or states they are licensed in, and must have taken and passed the NPTE, and graduated from a CAPTE accredited program. Applicants under this pathway will not need to submit NPTE test scores or transcripts. 
  
  To apply, applicants must submit the following: 
   
  • ​​​​Complete application and application fee
  • Verification of license(s) sent directly from the other jurisdiction to the department
  • Signed employer verification form verifying the applicant has worked lawfully as a PT or PTA for at least 200 hours in the past two years sent directly from the employer to the department
  • Signed attestation verifying they have taken and passed the NPTE and graduated from a CAPTE accredited program
    • Attestation is included in the application 

Am I required to take and pass the Washington State Jurisprudence Exam before I can qualify for a license?

Effective January 1, 2026, the Washington State Jurisprudence (JP) Exam is no longer a pre-licensure requirement. Instead, the jurisprudence exam is required once during the first full CE cycle for any PT or PTA who becomes licensed on or after January 1, 2026. After the first CE cycle, the JP exam is optional, can be taken once per CE cycle, and counts as one CE hour.  WAC 246-915-085.

Anyone licensed before January 1st will not have to retake the JP exam, but it is still an option for one free CE hour per CE cycle.

Is there a limit on how many times I can take the National Physical Therapy Exam (NPTE)?

You may take the NPTE a maximum of six times. However, you will not be allowed to test more than two times if you receive very low scores on your first two exams. A very low score is defined as performing at or below chance level (scale score four hundred and below) per WAC 246-915-030.

If I have a student-issued transcript or NPTE scores, can I send that with my application?

No. Per WAC 246-915-039, all required documentation must be sent directly from the issuing institution to: 

Department of Health 
Board of Physical Therapy 
P.O. Box 47877 
Olympia, WA 98504-7877

If I'm licensed in another state, may I begin practicing once you have my application?

No. You must have a valid Washington state physical therapy license or compact privilege before practicing as a physical therapist or physical therapist assistant. For additional information, review RCW 18.74.010.

You may consider a compact privilege as a way to practice in Washington state while your application is pending, if you are a resident of a state that participates in the compact and all other requirements are met.

How do I apply for a compact privilege?

Visit the Physical Therapy Compact website for more information on how to purchase your compact privilege. 

For foreign educated applicants, what credential evaluation agencies does Washington state accept?

The Board of Physical Therapy recognizes only the credential evaluation services listed below. Recognized credential evaluation services must use the appropriate Course Work Tool (CWT) adopted by the Federation of State Boards of Physical Therapy (FSBPT) to determine substantial equivalency. The appropriate CWT means the CWT in place at the time the foreign educated physical therapist earned their professional degree in physical therapy, per WAC 246-915-120. 

Foreign Credentialing Commission on Physical Therapy, Inc. (FCCPT) 
124 W. St. S., 3rd Floor 
Alexandria, VA 22314-1917 
703-684-8406 

International Consultants of Delaware, Inc. (ICD) 
3600 Market St., Ste. 450 
Philadelphia, PA 19104-2651 
215-222-8454, ext. 510, fax 215-349-0026 

International Education Research Foundation (IERF) 
P.O. Box 3665 
Culver City, CA 90231-3665 
310-258-9451

How much is my renewal fee?

If you renew on or before your birth date, you pay the annual fee. If you renew after your birth date, you pay the renewal and late penalty fees. Late penalty fees won’t be waived. 

For additional information, please review WAC 246-915-990 and WAC 246-915-99005.

How long does the renewal process take? 

Renewal notices are sent through email six to eight weeks before your expiration date to allow enough processing time. It's important to pay immediately to ensure that your license will be renewed on or before your expiration date. It’s against the law to work without a current license, and you’re required to post a copy of your license in a visible location at your worksite. RCW 18.74.150(1) and WAC 246-915-140.

It's important to plan ahead, don't leave your renewal to the last minute.  

Continuing Education

How many hours of continuing education am I required to report and when? 

Visit the physical therapist continuing education webpage or WAC 246-915-085 through WAC 246-915-086 for all continuing education requirements.

When am I required to take the jurisprudence exam?

Effective January 1, 2026, the Washington State Jurisprudence (JP) Exam has been removed as a pre-licensure requirement, and it is now required once during the first full CE cycle for all physical therapists and physical therapist assistants who became licensed on or after January 1, 2026. After the first CE cycle, the JP exam is optional, can be taken once per CE cycle and would count as one CE credit.

Anyone licensed before January 1st will not have to retake the JP exam, but it is still an option for one free CE hour per CE cycle.

Am I required to complete health equity training as part of my CE requirements?

Every two years, each physical therapist and physical therapist assistant shall complete two hours of health equity continuing competency training as described in WAC 246-12-800 through 246-12-830. For documentation, refer to the documentation required for the particular type of continuing education chosen. The hours spent completing health equity training continuing education count toward meeting any applicable continuing competency requirements.

If I hold any of the PT license endorsements, are my CE requirements different?

The only endorsement with CE requirements is the spinal manipulation endorsement. If you hold the spinal manipulation endorsement, 10 of your 32 hours of CE will need to be directly related to spinal manipulation with at least 5 hours related to procedural techniques and application of spinal manipulation. These hours can be counted towards your regular CE requirements. WAC 246-915-085.

I know I need 200 hours every two years in the application of physical therapy knowledge and skills - what should I do if I’ve taken a break from work or I’m using my license outside of the clinical setting?

There are several options outside of the clinical setting to meet your 200-hour continuing competency requirement ranging from consulting, to teaching, to job shadowing. Review WAC 246-915-085(7) for a full list of qualifying activities. 

License Status

Under my graduate interim permit, may I have more than one sponsoring physical therapist?

Yes. The law requires you to be directly supervised, including co-signature of notes, by a licensed physical therapist. WAC 246-915-078. Some interim permit holders work at more than one facility, which requires being sponsored by more than one supervising physical therapist.

Can I put my license “on hold”? 

You may put your license in an inactive status under WAC 246-12-090. While your license is inactive, you do not have to complete your CE and knowledge and skills hours, but once you request to return to active status, you will need to have those hours completed within the two years prior to your request. You may also be required to retake the National Physical Therapy Examination (NPTE), depending on how long your license has been in an inactive status. Review WAC 246-915-350 for more information. 

Email us if you have questions about your specific situation. 

How do I reactivate my inactive license?

You can access the application to reactivate your license on our webpage. 

Under WAC 246-915-350 a physical therapist or physical therapist assistant with an inactive credential for three years or less who wishes to return to active status shall meet the requirements of chapter 246-12 WAC, Part 4. 

A physical therapist or physical therapist assistant with an inactive credential for more than three years, who has been in active practice in another United States jurisdiction, and wishes to return to active status shall: 

• Submit verification of active practice from any other United States jurisdiction; and 
• Meet the requirements of chapter 246-12 WAC, Part 4. 

A physical therapist or physical therapist assistant with an inactive credential for more than three years, but less than five years, who has not been in active practice in another United States jurisdiction, and wishes to return to active status shall: 

• Successfully pass the NPTE as provided in RCW 18.74.035. The board may waive reexamination if the physical therapist or physical therapist assistant presents evidence of continuing competency satisfactory to the board; and 
• Shall meet the requirements of chapter 246-12 WAC, Part 4. 

A physical therapist or physical therapist assistant with an inactive credential for five years or longer, who has not been in active practice in another United States jurisdiction, and wishes to return to active status shall: 

• Meet the requirements of chapter 246-12 WAC, Part 4; and 
• Successfully retake and pass the NPTE as provided in RCW 18.74.035.
  
  Note: Under WAC 246-915-350, regardless of the amount of time your license was inactive, you are required to meet all continuing education activities before you can reactivate your license for the most recent two years, including the 200 hours involving the application of physical therapy knowledge and skills. Since you cannot work as a PT or PTA with an inactive license, you will be limited in what activities you can complete to meet this requirement. Review WAC 246-915-085(7) for a full list of qualifying activities.

How do I reactive my expired license?

You can access the application to reactivate your license on our webpage. 

Under WAC 246-915-050 if the license has expired for one renewal cycle or less, the applicant shall meet the applicable requirements of chapter 246-12 WAC, Part 2. 

If the license has expired for more than one renewal cycle and the applicant has been in active practice in another United States jurisdiction, the applicant shall: 

• Submit verification of active practice from the other United States jurisdiction; and 
• Meet the applicable requirements of chapter 246-12 WAC, Part 2. 

If the license has expired for more than one renewal cycle but less than five years, and the applicant has not been in active practice in another United States jurisdiction, the applicant shall meet the applicable requirements of chapter 246-12 WAC, Part 2. 

If the license has expired for five years or more, and the applicant has not been in active practice in another United States jurisdiction, the applicant shall meet applicable requirements of chapter 246-12 WAC, Part 2, and retake and pass the NPTE.

Note: Regardless of the amount of time your license was inactive, you are required to meet all continuing education activities before you can reactivate your license, including the 200 hours involving the application of physical therapy knowledge and skills. Since you cannot work as a PT or PTA with an inactive license, you will be limited in what activities you can complete to meet this requirement. Review WAC 246-915-085(7) for a full list of qualifying activities.

Supervision

As a physical therapist, how many assistive personnel may I supervise?

Under WAC 246-915-181 at any one time, you may supervise up to a total of three assistive personnel, who may be physical therapist assistants, other assistive personnel, or physical therapy aides. If you are supervising the maximum of three assistive personnel at any one time, no more than one of the assistive personnel may be a physical therapy aide. You have the sole discretion, based on your clinical judgment, to determine whether to utilize assistive personnel to provide services to the patient. 

If you are working in a nursing home, as defined in RCW 18.51.010, or in the public schools, as defined in RCW 28A.150.010, you may supervise a total of only two assistive personnel at any one time. 

In addition to the assistive personnel authorized in WAC 246-915-181, you may supervise a total of two persons who are pursuing a course of study leading to a degree as a physical therapist or a physical therapist assistant.

What is a physical therapy aide?

A physical therapy aide is defined under WAC 246-915-010 as an unlicensed person who receives ongoing on-the-job training and assists a physical therapist or physical therapist assistant in providing physical therapy patient care and who does not meet the definition of a physical therapist, physical therapist assistant, or other assistive personnel. A physical therapy aide may directly assist in the implementation of therapeutic interventions. However, they may not alter or modify the plan of therapeutic interventions nor perform any procedure or task that only a physical therapist may perform under Chapter 246-915 WAC.

If patient care is provided by a PTA or other assistive personnel, when is a physical therapist required to reevaluate a patient?

The physical therapist must reevaluate the patient the later of every fifth visit or every 30 days if a PT has not treated the patient for any of the five visits or within the 30 days, or if there is any change to the patient’s condition that is not consistent with planned progress or treatment goals.

The reevaluation is not necessarily required every fifth visit or every 30 days. It depends on which of those occurrences happens later unless there is any change in the patient's condition not consistent with planned progress or treatment goals, in which case reevaluation would be needed sooner.

For example:

If a patient has 5 or more appointments within a 30-day period, the PT would need to do the reevaluation at the end of the 30-day period, which is later in time than the fifth visit, assuming no change to the patient’s condition that is not consistent with the planned progress or treatment plan. If the patient is seen fewer than 5 times within a 30 day period, say the patient is only seen every two weeks, then the PT would need to do the reevaluation by the fifth appointment, which would be later than 30 days. 

Intramuscular Needling Endorsement

What is intramuscular needling?

Intramuscular needling is defined under RCW 18.74.010 as follows: "Intramuscular needling," also known as "dry needling," means a skilled intervention that uses a single use, sterile filiform needle to penetrate the skin and stimulate underlying myofascial trigger points and connective and muscular tissues for the evaluation and management of neuromusculoskeletal pain and movement impairments. Intramuscular needling requires an examination and diagnosis. Intramuscular needling does not include needle retention without stimulation or the stimulation of auricular and distal points.

What are the requirements to qualify for the intramuscular needling endorsement?

• The physical therapist must have at least one year of postgraduate practice experience that averages at least 36 hours a week and consists of direct patient care.
  • If the didactic and in-person instruction detailed below was completed through pre-licensure coursework, you do not need one year of postgraduate practice experience.
• A total of 100 hours of didactic instruction in the following areas:
  • Anatomy and physiology of the musculoskeletal and neuromuscular systems;
  • Anatomical basis of pain mechanisms, chronic pain, and referred pain;
  • Trigger point evaluation and management;
  • Universal precautions in avoiding contact with a patient's bodily fluids; and
  • Preparedness and response to unexpected events including but not limited to injury to blood vessels, nerves, and organs, and psychological effects or complications.
• A total of 75 hours of in-person intramuscular needling instruction in the following areas:
  • Intramuscular needling technique;
  • Intramuscular needling indications and contraindications;
  • Documentation and informed consent for intramuscular needling;
  • Management of adverse effects;
  • Practical psychomotor competency; and
  • Occupational safety and health administration's bloodborne pathogens protocol.
• After completing the 100 hours of didactic instruction and 75 hours of in-person instruction, the physical therapist must complete a successful clinical review of a minimum of 150 hours of at least 150 individual intramuscular needling treatment sessions by a qualified provider. The physical therapist has up to 18 months to complete the successful clinical review. 

Review RCW 18.74.200 and WAC 246-915-390 for further details.

My Commission on Accreditation in Physical Therapy Education (CAPTE) accredited physical therapy pre-licensure coursework covered the 100 hours of didactic training. Do I have to submit my transcripts again?

If you graduated from a CAPTE accredited physical therapy program, you will likely have completed all 100 hours of didactic instruction covering the required topics. Since you submitted transcripts to apply for your Washington state physical therapy license, you may not need to submit them again. If you feel you fall into this category, please submit your application with all additional supporting documentation, and the department will pull your transcripts from your existing record. If we are unable to access your transcripts, we will contact you.

How do I apply for the intramuscular needling endorsement?

You may access the application on our licensing information webpage. Currently, we are only able to accept paper applications for the intramuscular needling endorsement. When the online application is available, our website will be updated. Submit your application along with your supporting documentation and the $100 one-time fee to the address listed on the application. Only physical therapists (not physical therapist assistants) are eligible for this endorsement.

When can I start working on the intramuscular needling hours required under clinical review?

You can work through those hours once you have completed the 100 hours of didactic instruction and 75 hours of in-person instruction. The statute requires physical therapists to complete a successful clinical review of a minimum of 150 hours of at least 150 individual intramuscular needling treatment sessions under a qualified provider. You must complete this qualification after completing the didactic and in-person training and before applying for the endorsement.

Can I practice dry needling on an individual who is not a regular patient in my work setting to meet the 150 hours of at least 150 treatment session requirement?

Although it is not always recommended, you are not precluded from treating individuals that are known to you. A person does not have to be registered or necessarily paying for services to be considered a patient. Anyone you provide treatment to would need to have some kind of indication that dry needling could help them. A meaningful clinical review would not be possible for services provided to a person who had no indication for treatment. You must record and maintain chart notes which could be evaluated for the clinical review. You also need to be aware that under RCW 18.74.200, dry needling cannot be administered as a stand-alone treatment within a plan of care. 

How do I find a qualified provider to supervise my training hours?

Your qualified provider must have knowledge of intramuscular needling. A qualified provider can be one of the following: 

• A physician licensed under chapter 18.71 RCW; an osteopathic physician licensed under chapter 18.57 RCW; a licensed naturopath under chapter 18.36A RCW; a licensed acupuncture and Eastern medicine practitioner under chapter 18.06 RCW; or a licensed advanced registered nurse practitioner under chapter 18.79 RCW;
• A physical therapist credentialed to perform intramuscular needling in any branch of the United States armed forces;
• A licensed physical therapist who currently holds an intramuscular needling endorsement; or
• A licensed physical therapist licensed under the laws of another jurisdiction who meets the requirements of the intramuscular needling endorsement but does not currently hold a Washington endorsement. RCW 18.74.200 and WAC 246-915-390.

What if I have been performing intramuscular needling out of state already?

Any physical therapist performing intramuscular needling in Washington state is required to hold the endorsement, regardless of prior experience. The statute details specific training and education requirements for individuals to qualify for the endorsement.

A physical therapist licensed in Washington state and trained out of state to perform intramuscular needling may qualify for the endorsement. However, they must meet all the requirements under RCW 18.74.200, including the required time frames for completing the training and education.

This means a physical therapist trained to perform intramuscular needling out of state would need to complete the training and education requirements under RCW 18.74.200. This includes 150 hours of 150 treatment sessions under clinical review completed within 18 months of completing the didactic and in-person training.

What if I trained to perform intramuscular needling in the military?

Physical therapists licensed in Washington state and trained to perform intramuscular needling in any branch of the military qualify for the endorsement. WAC 246-915-390. The physical therapist applicant must submit evidence of their military credentials with their application. 

Will I be able to delegate intramuscular needling?

No, the statute does not allow physical therapists to delegate intramuscular needling to physical therapy assistants or any other assistive personnel. You must remain in constant attendance of the patient for the entirety of the procedure.

What if my patient is also seeing an acupuncturist?

Under RCW 18.74.200 physical therapists shall make reasonable efforts to coordinate care with the acupuncturist or acupuncture and Eastern medicine practitioner to avoid duplication of services when they intend to perform intramuscular needling on a patient who is being treated by an acupuncturist or acupuncture and Eastern medicine practitioner for the same diagnosis. 

Does my patient need to sign an informed consent form?

Yes. Under RCW 18.74.200 and WAC 246-915-390 physical therapists shall have patients receiving intramuscular needling sign an informed consent form that includes the following information:

• The definition of intramuscular needling as set forth in RCW 18.74.010;
• A description of the risks of intramuscular needling;
• A description of the benefits of intramuscular needling;
• A description of the potential side effects of intramuscular needling; and
• A statement clearly differentiating the procedure from the practice of acupuncture. Acupuncture shall be defined in accordance with the definition of "acupuncture and Eastern medicine" under RCW 18.06.010.

The Board of Physical Therapy, with input from our community partners, has developed an example of an informed consent form that includes all the required information. You are not required to use this example form, but feel free to copy some or all of the form for your own use. If you choose to create your own informed consent form or edit the example form, it must contain all the information listed above.