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Health Professions Defined
stethoscope lying on open-faced book
A list of all currently licensed and regulated health professions in Washington state and the educational requirements for each.

Health Professions Defined

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, and treat.

Know Who You're Seeing

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 RCW 18.120.020.

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 professions for updates.


Physicians and PAs

Physician

(a.k.a. "doctor of medicine," "allopathic physician," "physician," "surgeon," "MD")

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 information, see chapter 18.71 RCW.

Physician assistant

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.

Osteopathic physician

(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.

Osteopathic physician assistant

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.


Other Professions

Acupuncturist and Eastern medicine practitioner

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.

Behavior analyst, behavior technician

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.

Chiropractor

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.

Counselor

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 human potential.

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 information, see chapter 18.19 RCW.

Dental anesthesia assistant

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.

Dental hygienist

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 information, see chapter 18.29 RCW.

Dentist

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, or jaw.

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 information, see chapter 18.32 RCW.

Denturist

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.

Dietitian, nutritionist

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.

Educational requirements:
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.

Dispensing optician

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.

Embalmer, funeral director

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 final disposition.

Educational requirements:
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.

Emergency medical technician (first responder)

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.

Hearing aid specialist, audiologist, speech-language pathologist

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.

Educational requirements:
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.

Massage therapist, reflexologist

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.

Medical assistant

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.

Mental health counselors, marriage and family therapist, social worker

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.

Educational requirements:

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.

Midwife

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.

Naturopath

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.

Nurse

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 commission

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 registered nurse.

Educational requirements:

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 nursing commission.

For more information, see chapter 18.79 RCW.

Nursing assistant

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.

Nursing home administrator

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.

Occupational therapist

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.

Ocularist

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.

Optometrist

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.

Pharmacist

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 information, see chapter 18.64 RCW.

Pharmacy assistant

A person registered by the pharmacy quality assurance commission to perform limited functions in the pharmacy under the supervision of a licensed pharmacist.

Educational requirements: Completion of a pharmacy technician training program.

For more information, see chapter 18.64A RCW.

Physical therapist

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 condition.

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.

Podiatric physician and surgeon

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.

Psychologist

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 health.

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 technician

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 practitioner.

(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 physician.

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.

Respiratory care practitioner

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.

Veterinarian, veterinary technician

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.

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