Washington scope of practice for med spas
Who may perform which procedures, and under what supervision, by state. Below are the Washington rules that govern it, each linked to its primary source.
RN / NP scope for injectables in Washington
Registered nursing in Washington expressly includes executing a medical regimen prescribed by a physician, physician assistant or ARNP — and separately includes delegation. An ARNP’s expanded role is defined by the nursing board rather than by statute.
Advanced registered nursing practice means the acts of a registered nurse plus an expanded role “the scope of which is defined by rule by the board”, and on board approval an ARNP may prescribe legend drugs and controlled substances in Schedule V, and Schedules II through IV subject to statutory conditions. The statute grants the authority and hands the scope to the nursing board.
Wash. Rev. Code 18.79.050 · verified Sep 2, 2026
A physician assistant may use an LLRP device on skin with the consent of a participating physician and in accordance with standard medical practice, provided they are appropriately trained in the physics, safety and techniques of the device beforehand and remain competent for as long as it is used. Washington gives physician assistants their own rule rather than treating them as a delegate under the physician’s.
Wash. Admin. Code 246-918-125(4) and (5) · verified Sep 2, 2026
A physician assistant carries the same pre-treatment duties a physician does — history, appropriate physical examination, diagnosis, recommended treatment, informed consent INCLUDING telling the patient a nonphysician may operate the device, emergency and follow-up instructions, and an appropriate medical record — and may themselves delegate an LLRP procedure onward to a properly trained licensed professional whose own scope allows it, so long as it involves no surgery and the device is not used on the globe of the eye.
Wash. Admin. Code 246-918-125(6) and (7) · verified Sep 2, 2026
Registered nursing practice expressly includes the executing of a medical regimen as prescribed by a licensed physician and surgeon, osteopathic physician, podiatric physician, dentist, physician assistant or advanced registered nurse practitioner. The order may come from any of those; the nurse carrying it out is acting on it.
Wash. Rev. Code 18.79.040(1)(e) · verified Sep 2, 2026
It also includes the administration, supervision, DELEGATION and evaluation of nursing practice, and the observation, assessment, diagnosis, care and health teaching of individuals — acts requiring substantial specialized knowledge, judgment and skill. Delegation downward is part of the registered nurse’s own scope, not something borrowed from the physician.
Wash. Rev. Code 18.79.040(1)(a) and (c) · verified Sep 2, 2026
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MedSpaRadar is regulatory monitoring and reference: it summarizes public laws, regulations and agency actions and links each to its source. It is not legal, medical, or compliance advice, and using it creates no attorney-client relationship. A summary can lag its source or leave out detail, and monitoring itself can be interrupted — so an absence of alerts means nothing reached you, not that nothing happened. Read the cited source, check its effective date, and confirm any change to your operations or clinical practice with qualified health-law counsel and your medical director.