Washington Optometry Licensing for Out-of-State Optometrists

Washington's endorsement rule is one of the shortest in the country. Under WAC 246-851-500, the state may license without examination "an individual licensed in another state that has licensing standards substantially equivalent to those in Washington." There is no years-of-practice minimum and no exam before licensure. The catch is scope. Washington requires every optometrist licensed since January 1, 2007 to hold four drug certifications: diagnostic agents, topical therapeutic agents, oral medications and epinephrine by injection for anaphylactic shock. An optometrist from a state that does not train for all four has work to do before Washington will issue a license.

The details below come from the Washington State Department of Health (DOH) licensing requirements page, chapter 246-851 of the Washington Administrative Code and RCW 18.53.010.

Who can use Washington's endorsement rule?

WAC 246-851-500 says the license may be issued on receipt of:

• documentation from the state where you are licensed indicating that its licensing standards are substantially equivalent to Washington's current standards;
• a completed application and fees;
• verification from every state in which you hold a license, active or inactive, showing you are not subject to charges or discipline for unprofessional conduct or impairment; and
• certification that you have read RCW chapters 18.53, 18.54, 18.195 and 18.130 and WAC chapters 246-851 and 246-852.

The board may require more information to decide eligibility. DOH's page adds that you must list every state where you hold or held a credential, including any where you applied and were not granted one, and each jurisdiction completes the verification form and sends it directly to DOH. A yes answer to the professional liability claims question needs an explanation, the original complaint and the settlement or final disposition. For the mechanics of verifications, see ordering verifications from every state you have held.

Which drug certifications does Washington require?

DOH says applicants must pass NBEO Parts I, II, III and TMOD and "must also have endorsements for diagnostic and therapeutic pharmaceutical agents (DPA/TPA), oral medications and epinephrine by injection," with an official form from your school verifying the training. RCW 18.53.010(4) sets the training behind each:

• Topical therapeutics: an additional minimum of 75 hours of didactic and clinical instruction, with certification from an accredited institution.
• Oral medications: an additional minimum of 16 hours of didactic and eight hours of supervised clinical instruction.
• Epinephrine by injection for anaphylactic shock: an additional minimum of four hours of didactic and supervised clinical instruction.

Subsection (4)(f) states that everyone receiving an initial Washington license on or after January 1, 2007 must be certified in all four. If your school's curriculum did not include oral prescribing or epinephrine injection training, you will need a qualifying course and certification before the license can issue. When your home state's scope is narrower than the new state's walks through how to close that gap.

Is there a law exam?

Not before licensure. Endorsement applicants certify that they have read the statutes and rules. After licensure, WAC 246-851-090 requires a new licensee to pass the board-approved jurisprudence exam during their first full continuing education reporting period, and it counts for three hours of CE.

How much does a Washington license cost, and when does it renew?

WAC 246-851-990 sets the fees and the cycle. As of October 2026:

• Original application: $130, plus a $16 UW online access (HEAL-WA) fee.
• Active license renewal: $150, plus the $16 HEAL-WA fee.

"Licenses must be renewed every year on the practitioner's birthday." CE is counted over two years: WAC 246-851-090 requires 50 hours every two years, with at least 10 hours synchronous in person and no more than 25 asynchronous. At least 25 hours must be category 1 education from optometry-specific sources such as the AOA and its affiliates, ASCO schools, COPE-accredited courses and ARBO member boards. The chapter also includes rules on health equity CE and suicide prevention education.

One provision helps multi-state ODs: you may meet Washington's CE requirement by showing that you hold current American Board of Optometry certification, or that you practice solely outside Washington and meet the CE requirements of the state where you practice. Optometry CE requirements across states covers the overlap.

What are Washington's advanced procedures, and do they include lasers?

Washington has an advanced procedures endorsement under RCW 18.53.010(2) and WAC 246-851-515, separate from the license. To earn it, you show a board-approved course with supervised hands-on experience on live patients from an accredited institution, pass either NBEO's national exam for advanced procedures or the course's exam, and enter a rapid-response agreement with a qualified physician for complications. Every advanced procedure, with any complications, is reported each year through a reporting period that ends December 31, 2028.

Washington's advanced procedures do not include lasers. RCW 18.53.010(3) excludes retinal laser procedures, LASIK, PRK and other refractive surgery other than light adjustable lens procedures, and subsection (10) says nothing in the chapter authorizes optometrists to perform ophthalmic surgery, defined to include tissue "cut, ablated, or otherwise penetrated by incision, injection, laser, ultrasound, or other means" to treat eye disease or alter refraction or appearance. Diagnostic laser instruments are not affected. How states decide on laser procedures compares Washington with states that do authorize them.

What can a Washington optometrist prescribe?

Under RCW 18.53.010, diagnostic and therapeutic agents exclude Schedule I and II drugs, except hydrocodone combination products. An optometrist may not prescribe, dispense or administer a controlled substance for more than seven days for a single trauma, episode or condition; longer treatment means referral to a physician. If you prescribe controlled substances in Washington, you also need a DEA registration for Washington; see DEA registration for optometrists in more than one state.

Should you hand off the Washington paperwork?

Our Optometry License, One State service is $699 for Washington. We check your training against the four required certifications before you file, request your school's verification form and verifications from every state on your list, prepare the endorsement application and statutes certification with a question-by-question guide, and track it with DOH. You answer and sign the application and certification and pay DOH. If you plan to add the advanced procedures endorsement later, our Laser and Advanced Procedure Credential ($399 per state) organizes the course, exam and rapid-response agreement documentation. Annual Renewal and CE Tracking ($299 per license, per year) keeps the birthday renewal and the two-year CE count in sync. See the Washington licensing page to compare states.