Scope of Practice
Who Can Legally Perform Aesthetic Treatments in Washington?
Which license types can legally perform each treatment in Washington, with the conditions — sourced from official state boards.
Last reviewed June 2026
Neurotoxin injections (Botox / Dysport) in Washington
Details →Esthetician (LE)
Master Esthetician
Medical Assistant (MA)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
Dermal filler injections in Washington
Details →Esthetician (LE)
Master Esthetician
Medical Assistant (MA)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
Weight-loss injections (semaglutide / tirzepatide) in Washington
Details →Esthetician (LE)
Master Esthetician
Medical Assistant (MA)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
Kybella (deoxycholic acid) injections in Washington
Details →Esthetician (LE)
Master Esthetician
Medical Assistant (MA)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
PRP / PRF ("vampire facial") in Washington
Details →Esthetician (LE)
Master Esthetician
Medical Assistant (MA)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
Laser hair removal in Washington
Details →Esthetician (LE)
Permitted under general physician supervision — a physician is available (e.g., by phone) but need not be present. Requires a physician to be available but not on-site.
Master Esthetician
Permitted for this license type.
Medical Assistant (MA)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
Laser skin resurfacing in Washington
Details →Esthetician (LE)
Master Esthetician
Medical Assistant (MA)
Registered Nurse (RN)
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
IPL / photofacial in Washington
Details →Esthetician (LE)
Permitted under general physician supervision — a physician is available (e.g., by phone) but need not be present. Requires a physician to be available but not on-site.
Master Esthetician
Permitted for this license type.
Medical Assistant (MA)
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
RF microneedling (e.g. Morpheus8) in Washington
Details →Esthetician (LE)
Permitted under general physician supervision — a physician is available (e.g., by phone) but need not be present. Requires a physician to be available but not on-site.
Master Esthetician
Permitted under general physician supervision — a physician is available (e.g., by phone) but need not be present. Requires general supervision by a licensed physician.
Medical Assistant (MA)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
Microneedling in Washington
Details →Esthetician (LE)
Permitted under general physician supervision — a physician is available (e.g., by phone) but need not be present. Requires a physician to be available but not on-site.
Master Esthetician
Permitted for this license type.
Medical Assistant (MA)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
Chemical peels in Washington
Details →Esthetician (LE)
Permitted under general physician supervision — a physician is available (e.g., by phone) but need not be present. Requires a physician to be available but not on-site.
Master Esthetician
Permitted for this license type.
Medical Assistant (MA)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
Dermaplaning in Washington
Details →Esthetician (LE)
Permitted for this license type.
Master Esthetician
Permitted for this license type.
Medical Assistant (MA)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
Med-Spa Rules in Washington
Does this state require a physician medical director for a med spa?
Permitted
Is a good-faith exam (by a physician, NP, or PA) required before treatment?
ConditionalA good-faith exam is required before treatment by a physician, NP, or PA.
Do nurse practitioners have full (independent) practice authority in this state?
Permitted
May a physician delegate cosmetic injections to qualified staff (e.g., RN) under supervision?
ConditionalA physician may delegate cosmetic injections to qualified staff under supervision.
Can a non-physician legally own a medical spa in this state? (corporate practice of medicine)
Not permitted
Looking for a qualified provider in Washington?
Every provider on Elite Aesthetics Guide is independently evaluated, and many are credential-verified.
Find providers in Washington →Sources
Elite Aesthetics Guide provides consumer information to help you find and vet qualified providers. This is general information, not medical or legal advice, and regulations change — always confirm with the official state board. Consult a licensed provider for any treatment decision.