Practice Agreement · NP
Nurse Practitioner Practice Agreement in Washington
Washington law does not require a Nurse Practitioner to hold a named agreement with a physician. Practices still use one to define the working relationship; here is what it covers and what the state does require.
Washington is a longstanding full-practice-authority state — ARNPs (which includes NP) are licensed independent practitioners under RCW 18.79 with no physician agreement of any kind required, verified current for 2026 against WAC 246-840-300.
What a Nurse Practitioner practice agreement covers in Washington
Governed by the Washington State Board of Nursing and the Washington State Pharmacy Quality Assurance Commission. Each numbered item is a statutory requirement the agreement must satisfy.
Washington does not require the Nurse Practitioner to enter into a collaboration or supervision agreement with a physician, and no minimum-hours transition period applies. The Nurse Practitioner practices, diagnoses, and prescribes, including Schedule II through V controlled substances with a DEA registration, under the Nurse Practitioner's own license, consistent with RCW 18.79.250 and WAC 246-840-300.
This Agreement's terms regarding the Nurse Practitioner accordingly serve to define the working relationship, referral pathways, and any Medical Director oversight between the Parties, and are not themselves required by Washington law as a condition of the Nurse Practitioner's authority to practice.
- The agreement on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.
Statutes and rules cited
- WAC 246-945-350regulation
Washington State Pharmacy Quality Assurance Commission rule setting the mandatory minimum content and filing requirement for a Collaborative Drug Therapy Agreement (CDTA).
- RCW 18.64.011statute
Washington Pharmacy Practice Act definitions, including 'practitioner' and the statutory basis for pharmacist prescriptive authority under a CDTA.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the agreement has to carry, from the state's supervision rules.
Proximity
No proximity requirement
No physician-oversight relationship exists — ARNPs are licensed independent practitioners under WAC 246-840-300.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
Schedule II-V upon Board of Nursing prescriptive-authority approval (RCW 18.79.240); Schedule I remains off-limits by statute. Requires an additional 15 hours/2-year-cycle of pharmacotherapeutics CE beyond the base 30-hour ARNP CE requirement.
Written agreement
Not required
Unconditional — no collaborating-physician agreement of any kind is required for ARNP/NP licensure or practice in Washington.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional Service Corporation under RCW 18.100.050 — NPs are one of 12 enumerated health professions eligible to co-own a multi-discipline PSC (alone or with physicians/PAs/other listed professions); non-licensees may not hold equity.
Legal sources for these rules (3)
About Washington's rules
Washington is a full-independence state for ALL FOUR ARNP roles (NP, CRNA, CNM, CNS) under RCW 18.79, not just NPs — confirmed current via WAC 246-840-300/420 and Board of Nursing guidance. PAs are separate: HB 2041 (eff. Jan. 1, 2025) replaced supervision-only with a 4,000-hour supervision→collaboration tier (RCW 18.71A.120) with no numeric ratio cap.
Other clinicians in Washington: see the state overview.