Patients are often confused about the differences between various types of
health care professionals. Often, patients mistakenly believe they are meeting
with physicians (medical doctors or doctors of osteopathic medicine) when they
are not. Confusion about who is and who is not qualified to provide specific
patient care undermines the reliability of the health care system and can put
patients at risk. People unqualified to perform health services can lead to
medical errors and patient harm.
Patients deserve to know who provides their health care, and exactly what
their health care providers are qualified and licensed to diagnose, prescribe,
In Washington state, licensed or regulated health professions are defined, and
education requirements outlined, in the Revised Code of Washington, the
compilation of all permanent laws now in force. Definitions are found in
Below is a list of all currently licensed and regulated health professions in
Washington state as of 2022, and the educational requirements for licensing or
certification of each profession. The information below is intended for
general guidance. Regulations are updated over time, so refer to the
Revised Code of Washington's chapter on the regulation of health
(a.k.a. "doctor of medicine," "allopathic physician," "physician," "surgeon,"
A physician is one who offers or undertakes to diagnose, cure, advise or
prescribe for any human disease, ailment, injury, infirmity, deformity, pain
or other condition, physical or mental, real or imaginary, by any means or
instrumentality; administers or prescribes drugs or medicinal preparations to
be used by any other person.
A resident physician means an individual who has graduated from a school of
medicine and is serving a period of postgraduate clinical medical training
sponsored by a college or university in this state or by a hospital accredited
by this state. Includes individuals designated as intern or medical fellow.
Educational requirements: A doctoral degree from a school of
medicine, and two years of postgraduate medical training. For more
chapter 18.71 RCW.
A person who is licensed by the commission to practice medicine to a limited
extent only under the supervision of a physician
Educational requirements: An accredited physician assistant
program; an examination. For more information, see
chapter 18.71A RCW.
(a.k.a. "doctor of osteopathy," "physician," "surgeon," "DO")
An osteopathic physician practices medicine involving the use of any and all
methods in the treatment of disease, injuries, deformities, and all other
physical and mental conditions in and of human beings, including the use of
osteopathic manipulative therapy.
Educational requirements: Doctoral degree from an accredited
school of osteopathic medicine and surgery, and not less than one year served
in a postgraduate training program. For more information, see
chapter 18.57 RCW.
An osteopathic physician assistant is a person who practices osteopathic
medicine to a limited extent under the supervision and control of an
osteopathic physician licensed in this state.
Educational requirements: Completion of a board-approved
accredited physician assistant program. For more information, see
chapter 18.57A RCW.
An acupuncture and Eastern medicine practitioner utilizes acupuncture or
Eastern medicine diagnosis and treatment to promote health and treat organic
or functional disorders, which includes a variety of traditional and modern
acupuncture and Eastern medicine therapeutic treatments, such as the practice
of acupuncture techniques and herbal medicine to maintain and promote
wellness, prevent, manage, and reduce pain, and treat substance use disorder.
Educational requirements: A course of didactic training in
basic sciences and acupuncture over a minimum period of two academic years;
Successfully completed five hundred hours of clinical training in acupuncture
or Eastern medicine. For more information, see
chapter 18.06 RCW.
A licensed behavior analyst identifies functional relations between behavior
and environmental factors and assists individuals in developing new behaviors,
increasing or decreasing existing behaviors, and emitting behaviors under
specific environmental conditions. A behavior technician is a paraprofessional
who implements a behavior analysis treatment plan under the supervision of a
licensed behavior analyst or a licensed assistant behavior analyst.
Educational requirements: For a licensed behavior analyst,
completion of a minimum of two hundred twenty-five classroom hours at graduate
level instruction in specific behavior analysis topics; successful completion
of a supervised experience requirement, consisting of a minimum of one
thousand five hundred hours; and successful completion of an examination. For
a behavior technician, successful completion of a training program of at least
forty hours and proof of ongoing supervision by a licensed behavior analyst.
For more information, see
chapter 18.380 RCW.
A chiropractor practices the diagnosis or analysis and care or treatment of
the vertebral subluxation complex and its effects, articular dysfunction, and
musculoskeletal disorders, all for the restoration and maintenance of health
and recognizing the recuperative powers of the body.
Educational requirement: Not less than one-half of the
requirements for a baccalaureate degree at a college or university; graduation
from a chiropractic school or college; evidence of completion of a resident
course of study of not less than four thousand classroom hours of instruction
in such school or college. For more information, see
chapter 18.25 RCW.
A counselor includes those employing any therapeutic techniques, including but
not limited to social work, mental health counseling, marriage and family
therapy, and hypnotherapy, that offer, assist, or attempt to assist an
individual or individuals in the amelioration or adjustment of mental,
emotional, or behavioral problems, and includes therapeutic techniques to
achieve sensitivity and awareness of self and others and the development of
Educational requirements: Have a bachelor's degree in a
counseling-related field, if applying for certified counselor; or an associate
degree in a counseling-related field and a supervised internship, if applying
for certified adviser; Pass an examination in risk assessment, ethics,
appropriate screening and referral, and Washington state law. For more
chapter 18.19 RCW.
A dental anesthesia assistant, under close supervision of an oral and
maxillofacial surgeon or dental anesthesiologist, may administer general
anesthesia, sedation, or medication to a patient to assist the oral and
maxillofacial surgeon or dental anesthesiologist.
Educational requirements: Completion of a commission-approved
dental anesthesia assistant training course, to include intravenous access or
phlebotomy and training for starting and maintaining intravenous lines;
completion of a basic life support/cardiac pulmonary resuscitation course; and
a valid general anesthesia permit of the oral and maxillofacial surgeon or
dental anesthesiologist where the assistant will be performing his or her
services. For more information, see
chapter 18.350 RCW.
A dental hygienist may remove deposits and stains from the surfaces of the
teeth, may apply topical preventive or prophylactic agents, may polish and
smooth restorations, may perform root planning and soft-tissue curettage, and
may perform other dental operations and services delegated to them by a
licensed dentist. Such licensed dental hygienists may perform dental
operations and services only under the supervision of a licensed dentist.
Educational requirements: An educational program that
includes course work encompassing the subject areas within the scope of the
license to practice dental hygiene in the state of Washington; an examination
administered or approved by the dental hygiene examining committee. For more
chapter 18.29 RCW.
A dentist is a person able to diagnose, treat, remove stains and concretions
from teeth, operate or prescribe for any disease, pain, injury, deficiency,
deformity, or physical condition of the human teeth, alveolar process, gums,
Educational requirements: Graduation from a dental college,
school, or dental department of an institution approved by the Washington
state dental quality assurance commission; an examination prepared or approved
by and administered under the direction of the commission. For more
chapter 18.32 RCW.
A denturist is a person licensed to engage in the practice of making, placing,
constructing, altering, reproducing, or repairing a denture; and taking
impressions and furnishing or supplying a denture directly to a person or
advising the use of a denture, and maintaining a facility for the same.
Educational requirements: Formal training with a major course
of study in denturism of not less than two years in duration; a written and
clinical examination. For more information, see
chapter 18.30 RCW.
A dietitian uses the integration and application of scientific principles of
food, nutrition, biochemistry, physiology, management, and behavioral and
social sciences in counseling people to achieve and maintain health. A
nutritionist provides general nutrition services, or the counseling or
educating of groups or individuals in the selection of food to meet normal
nutritional needs for health maintenance.
For a dietitian, a major course of study in human nutrition, foods and
nutrition, dietetics, or food systems management, and a baccalaureate or
higher degree from a college or university; continuous preprofessional
experience in dietetic practice of not less than nine hundred hours under the
supervision of a certified dietitian or a registered dietitian or completion
of a coordinated undergraduate program in dietetics; an examination; and
courses of continuing education.
For a nutritionist, the qualifications required to be a certified dietitian;
or a master's degree or doctorate degree in one of the following subject
areas: Human nutrition, nutrition education, foods and nutrition, or public
health nutrition from a college or university.
For more information, see
chapter 18.138 RCW.
A dispensing optician is a person who prepares duplications of, or prepares
and dispenses lenses, spectacles, eyeglasses on written prescriptions from
physicians or optometrists, and measures, adapts, adjusts and fabricates
lenses, spectacles, eyeglasses for the aid or correction of visual or ocular
anomalies of the human eye.
Educational requirements: Graduation from an accredited high
school; at least three years of apprenticeship training; or successful
completion of a prescribed course in opticianry in a college or university.
For more information, see
chapter 18.34 RCW.
A funeral director is a person engaged in the profession or business of
providing for the care, shelter, transportation, and arrangements for the
disposition of human remains that may include arranging and directing funeral,
memorial, or other services. An embalmer is a person engaged in the profession
or business of disinfecting and preserving human remains for transportation or
For a funeral director, an associate of arts degree in mortuary science or
completion of a course of not less than two years in an accredited college,
and a one-year course of training under a licensed funeral director in this
state. Must also pass an examination in the funeral arts and an examination in
the laws of this state pertaining to the handling, care, transportation, and
disposition of human remains.
An embalmer must obtain an associate of arts degree in mortuary science or
complete a course of instruction in an accredited mortuary science college
program and other college courses that total sixty semester hours or ninety
quarter hours, complete a two-year course of training under a licensed
embalmer in this state, and pass an examination in the funeral sciences and an
examination in the laws of this state pertaining to the handling, care,
transportation, and disposition of human remains.
For more information, see
chapter 18.39 RCW.
An emergency medical technician or first responder renders medical treatment
and care at the scene of any medical emergency or while transporting any
patient in an ambulance to an appropriate medical facility, including
ambulance transportation between medical facilities.
Educational requirements: An emergency medical technician
course; training under the supervision of an approved medical program director
according to training standards prescribed in rule to perform life-support
services; works under the medical oversight and protocols of a medical program
director and within their scope of practice, are able to meet certification
training requirements, and are provided with necessary medical equipment to
provide care at their level of certification. For more information, see
chapter 18.73 RCW.
A hearing aid specialist engages in the practice of fitting and dispensing of
hearing instruments. An audiologist engages in the application of principles,
methods, and procedures related to hearing and the disorders of hearing and to
related language and speech disorders. A speech-language pathologist engages
in the application of principles, methods, and procedures related to the
development and disorders, whether of organic or nonorganic origin, that
impede oral, pharyngeal, or laryngeal sensorimotor competencies and the normal
process of human communication.
A hearing aid specialist must complete a required examination and complete a
minimum of a two-year degree program. A speech-language pathologist or
audiologist must have a master's degree or a doctorate degree from a program
at an institution of higher learning, which includes completion of a
supervised clinical practicum experience, and has completed postgraduate
professional work experience. For more information, see
chapter 18.35 RCW.
A massage therapist provides a service involving the external manipulation or
pressure of soft tissue for therapeutic purposes. Massage therapy does not
include diagnosis or attempts to adjust or manipulate any articulations of the
body or spine. A reflexologist provides a service that is limited to applying
alternating pressure with thumb and finger techniques to reflexive areas of
the lower one-third of the extremities, feet, hands, and outer ears based on
reflex maps.Reflexology does not include the diagnosis of or treatment for
specific diseases, or joint manipulations.
Educational requirements: For a massage therapist, a course
of study in an approved massage program or approved apprenticeship program and
completion of an examination administered or approved by the Washington state
board of massage. For a reflexologist, a course of study in an approved
reflexologist program and completion of an examination administered or
approved by the Washington secretary of health. For more information, see
chapter 18.108 RCW.
A medical assistant-certified is certified by the state to assist a health
care practitioner with patient care and executes administrative, clinical, and
other procedures under the supervision of the health care practitioner. A
medical assistant-registered is endorsed by a health care practitioner,
clinic, or group practice to assist a health care practitioner with patient
care, execute administrative, clinical, and other procedures under the
supervision of the health care practitioner.
Educational requirements: For a medical assistant-certified,
completion of a medical assistant training program, and an examination, as
well as certain additional qualifications. For a medical assistant-registered,
a current endorsement from a health care practitioner, clinic, or group
practice and an attestation of the endorsement to perform specific medical
tasks signed by a supervising health care practitioner filed with the
department. For more information, see
chapter 18.360 RCW.
An advanced social worker applies social work theory and methods including
emotional and biopsychosocial assessment, psychotherapy under the supervision
of a licensed independent clinical social worker, case management,
consultation, advocacy, counseling, and community organization.
An independent clinical social worker diagnoses and treats emotional and
mental disorders based on knowledge of human development, the causation and
treatment of psychopathology, psychotherapeutic treatment practices, and
social work practice as defined in advanced social work.
A marriage and family therapist diagnoses and treats mental and emotional
disorders, whether cognitive, affective, or behavioral, within the context of
relationships, including marriage and family systems.
A mental health counselor applies principles of human development, learning
theory, psychotherapy, group dynamics, and etiology of mental illness and
dysfunctional behavior to individuals, couples, families, groups, and
organizations, for the purpose of treatment of mental disorders and promoting
optimal mental health and functionality.
For a social worker: a master's or doctorate social work educational program;
an approved examination; a supervised experience requirement (a minimum of
three thousand two hundred hours with ninety hours of supervision by a
licensed independent clinical social worker or a licensed advanced social
worker who has been licensed or certified for at least two years; continuing
education requirements of thirty-six hours, with six in professional ethics).
For an independent clinical social worker: a master's or doctorate level
social work educational program; an approved examination; a supervised
experience requirement (a minimum of four thousand hours of experience, of
which one thousand hours must be direct client contact, over a three-year
period supervised by a licensed independent clinical social worker who has
been licensed or certified for at least five years and who has had at least
one year of experience in supervising the clinical social work practice of
others, with supervision of at least one hundred thirty hours by a licensed
mental health practitioner; continuing education requirements of thirty-six
hours, with six in professional ethics).
For a mental health counselor: a master's or doctoral level educational
program in mental health counseling or a related discipline from a college or
university; an approved examination; a supervised experience requirement (a
minimum of thirty-six months full-time counseling or three thousand hours of
postgraduate mental health counseling under the supervision of a qualified
licensed mental health counselor in an approved setting; continuing education
requirements of thirty-six hours, with six in professional ethics).
For a marriage and family therapist - a master's degree or doctoral degree
educational program in marriage and family therapy or graduation from an
educational program in an allied field equivalent to a master's degree or
doctoral degree in marriage and family therapy; passage of an approved
examination; a supervised experience requirement (a minimum of two calendar
years of full-time marriage and family therapy; continuing education
requirements of thirty-six hours, with six in professional ethics).
For more information, see
chapter 18.225 RCW.
A midwife is one who renders medical aid for a fee or compensation to a woman
during prenatal, intrapartum, and postpartum stages or to her newborn up to
two weeks of age. A midwife must consult with a physician whenever there are
significant deviations from normal in either the mother or the newborn.
Educational requirements: A high school degree or its
equivalent, a certificate or diploma from a midwifery program, and the
following: (a) a minimum period of midwifery training for at least three
years; (b) minimum educational requirements; (c) undertaking the care of not
less than fifty women in each of the prenatal, intrapartum, and early
postpartum periods; and (d) observing an additional fifty women in the
intrapartum period. For more information, see
chapter 18.50 RCW.
A naturopath practices the art and science of the diagnosis, prevention, and
treatment of disorders of the body by stimulation or support, or both, of the
natural processes of the human body.
Educational requirements: Successful completion of a
doctorate degree program in naturopathy, which includes a minimum of two
hundred post-graduate hours in the study of mechanotherapy from an approved
educational program. For more information, see
chapter 18.36A RCW.
A registered nurse's responsibilities include the observation, assessment,
diagnosis, care or counsel, and health teaching of individuals with illnesses,
injuries, or disabilities, or in the maintenance of health or prevention of
illness of others; the executing of medical regimen (administer medications,
treatments, tests, and inoculations) as prescribed by a licensed physician and
surgeon, dentist, osteopathic physician and surgeon, podiatric physician and
surgeon, physician assistant, osteopathic physician assistant, or advanced
registered nurse practitioner.
An advanced registered nurse's responsibilities include the performance of the
acts of a registered nurse and the performance of an expanded role in
providing health care services as recognized by the medical and nursing
professions. Prescribe legend drugs and Schedule V controlled substances, and
Schedules II through IV within the scope of practice defined by the nursing
A licensed practical nurse's responsibilities include the performance of
services requiring the knowledge, skill, and judgment necessary for carrying
out selected aspects of the designated nursing regimen under the direction and
supervision of a licensed physician and surgeon, dentist, osteopathic
physician and surgeon, physician assistant, osteopathic physician assistant,
podiatric physician and surgeon, advanced registered nurse practitioner, or
For a registered nurse, a diploma from an approved school of nursing; must
pass an examination in subjects determined by the nursing commission.
For an advanced registered nurse, completion of an advanced registered nurse
practitioner training program; must pass an examination in subjects determined
by the nursing commission
For a licensed practical nurse, a high school diploma or general education
development certificate or diploma, completion of an approved practical
nursing program, and must pass an examination in subjects determined by the
For more information, see
chapter 18.79 RCW.
A nursing assistant is an individual, regardless of title, who, under the
direction and supervision of a registered nurse or licensed practical nurse,
assists in the delivery of nursing and nursing-related activities to patients
in a health care facility.
Educational requirements: Completion of an approved training
program or successful completion of alternate training meeting established
criteria approved by the Washington nursing care quality assurance commission;
a competency evaluation. For more information, see
chapter 18.88A RCW.
A nursing home administrator is an individual qualified by education,
experience, training, and examination to administer a nursing home.
Educational requirements: A baccalaureate degree; successful
completion of a practical experience requirement as determined by the state
board of nursing home administrators. For more information, see
chapter 18.52 RCW.
An occupational therapist is a person who utilizes purposeful, science-based
activity with individuals who are limited by physical injury or illness,
psychosocial dysfunction, developmental or learning disabilities, or the aging
process to maximize independence, prevent disability, and maintain health.
Educational requirements: An educational program in
occupational therapy, with concentration in biological or physical science,
psychology, sociology, and with education in selected manual skills; a period
of supervised fieldwork experience or a training program (for an occupational
therapist, a minimum of six months of supervised fieldwork experience is
required. For an occupational therapy assistant, a minimum of two months of
supervised fieldwork experience is required). For more information, see
chapter 18.59 RCW.
An ocularist designs, fabricates, and fits ocular prosthetic appliances. An
ocularist is authorized to perform the necessary procedures to provide an
ocular prosthetic service for the patient in the ocularist's office or
laboratory on referral of a physician.
Educational requirements: High school diploma or a general
equivalency degree, at least ten thousand hours of apprenticeship training
under the direct supervision of a licensed ocularist; or (a) completing a
prescribed course in ocularist training programs; or (c) completing at least
ten thousand hours of apprenticeship training under the direct supervision of
a practicing ocularist. For more information, see
chapter 18.55 RCW.
An optometrist practices health care involving the examination of the human
eye, the examination and ascertaining any defects of the human vision system,
and the analysis of the process of vision.
Educational requirements: A diploma or other certificate of
completion from an accredited college of optometry or school of optometry. For
more information, see
chapter 18.53 RCW.
A pharmacist is responsible for: Interpreting prescription orders; the
compounding, dispensing, labeling, administering, and distributing of drugs
and devices; the monitoring of drug therapy and use; the initiating or
modifying of drug therapy in accordance with written guidelines or protocols
previously established and approved for his or her practice by a practitioner
authorized to prescribe drugs; the participating in drug utilization reviews
and drug product selection; the proper and safe storing and distributing of
drugs and devices and maintenance of proper records thereof; the providing of
information on legend drugs which may include, but is not limited to, the
advising of therapeutic values, hazards, and the uses of drugs and devices.
Educational requirements: A baccalaureate degree in pharmacy
or a doctor of pharmacy degree granted by a school or college of pharmacy, and
internship experience, by practice in any licensed pharmacy. For more
chapter 18.64 RCW.
A person registered by the pharmacy quality assurance commission to perform
limited functions in the pharmacy under the supervision of a licensed
Educational requirements: Completion of a pharmacy technician
For more information, see
chapter 18.64A RCW.
A physical therapist treats any bodily or mental condition by the use of the
physical, chemical, and other properties of heat, cold, air, light, water,
electricity, sound, massage, and therapeutic exercise, which includes posture
and rehabilitation procedures; the performance of tests and measurements of
neuromuscular function as an aid to the diagnosis or treatment of any human
Educational requirements: A baccalaureate degree in physical
therapy from an institution of higher learning or a baccalaureate degree from
an institution of higher learning; a certificate or advanced degree from a
school of physical therapy. For more information, see
chapter 18.74 RCW.
A podiatric physician and surgeon is responsible for the quality of podiatric
care, which involves the diagnosis and the medical, surgical, mechanical,
manipulative, and electrical treatments of ailments of the human foot.
Educational requirement: A course in a school of podiatric
medicine and surgery; one year of postgraduate podiatric medical training. For
more information, see
chapter 18.22 RCW.
A psychologist engages in the observation, evaluation, interpretation, and
modification of human behavior by the application of psychological principles,
methods, and procedures for the purposes of preventing or eliminating
symptomatic or maladaptive behavior and promoting mental and behavioral
Educational requirements: A doctoral degree obtained from an
integrated program of graduate study in psychology; no fewer than two years of
supervised experience, at least one of which shall have been obtained
subsequent to the granting of the doctoral degree; written or oral
examinations. For more information, see
chapter 18.83 RCW.
Radiologic technologist is an individual certified under this chapter, other
than a licensed practitioner, who practices radiologic technology as a:
(a) Diagnostic radiologic technologist, a person who handles X-ray equipment
in the process of applying radiation on a human being for diagnostic purposes
at the direction of a licensed practitioner.
(b) Therapeutic radiologic technologist, a person who uses
radiation-generating equipment for therapeutic purposes on human subjects at
the direction of a licensed practitioner.
(c) Nuclear medicine technologist, a person who prepares radiopharmaceuticals
and administers them to human beings for diagnostic and therapeutic purposes
and who performs in vivo and in vitro detection and measurement of
radioactivity for medical purposes at the direction of a licensed
(d) Radiologist assistant, an advanced-level certified diagnostic radiologic
technologist who assists radiologists by performing advanced diagnostic
imaging procedures under supervision of a physician.
(e) Cardiovascular invasive specialist, a person who assists in cardiac or
vascular catheterization procedures under the personal supervision of a
Educational requirements: For a diagnostic radiologic
technologist, therapeutic radiologic technologist, or nuclear medicine
technologist: Graduation from an approved school or successful completion of
alternate training that meets the criteria established by the secretary of
health; completion of a radiologic technologist examination. For a radiologist
assistant: completion of an approved radiologist assistant program and a
radiologist assistant examination
For a cardiovascular invasive specialist, completion of a cardiovascular
invasive specialist program and a cardiovascular invasive specialist
examination. For more information, see
chapter 18.84 RCW.
A respiratory care practitioner is employed in the treatment, management,
diagnostic testing, rehabilitation, and care of patients with deficiencies and
abnormalities which affect the cardiopulmonary system and associated aspects
of other systems, and is under the direct order and under the qualified
medical direction of a physician.
Educational requirements: Graduation from a school approved
by the secretary of health or successful completion of alternate training
which meets the criteria established by the secretary; an examination;
completion of experience requirement. For more information, see
chapter 18.89 RCW.
A veterinarian diagnoses or prognoses or treats diseases, deformities,
defects, wounds, or injuries of animals; prescribes or administers any drug,
medicine, treatment, method or practice, or performs any operation,
manipulation, or applies any apparatus or appliance for cure, amelioration,
correction or reduction or modification of any animal disease, deformity,
defect, wound or injury. A veterinary technician provides limited veterinary
services under the supervision of a veterinarian.
Educational requirements: For a veterinarian, graduation from
a veterinary college. For a veterinary technician,completion of required
examinations administered or approved by the veterinary board of governors;
and completion of a post-high school course approved by the board in the care
and treatment of animals. For more information, see
chapter 18.92 RCW.