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How to Get an Occupational Therapist License in Washington (2026)
Washington State is an OT Compact member, giving eligible occupational therapists the fastest path to practice privileges — typically 1–3 days via compact.aota.org instead of 6–12 weeks for full endorsement.
Washington OT license at a glance
- Issuing board: Washington State Department of Health — Occupational Therapy Section
- OT Compact member: Yes
- Application fee: ~$200
- Processing time (compact): 1–3 business days
- Processing time (endorsement): 8–12 weeks
- NBCOT required: Yes
- CEU requirement (renewal): 30 hours per 2-year cycle
Washington OT compensation 2026
| Setting | Annual Salary Range |
|---|---|
| Hospital / acute care | $85K–$110K |
| SNF / long-term care | $76K–$100K |
| Outpatient / clinic | $74K–$96K |
| School system | $72K–$92K |
| Home health | $80K–$105K |
Where OT demand is highest in Washington State
- Seattle metro: UW Medicine, Virginia Mason Franciscan Health, Swedish Health Services, Seattle Children's
- Tacoma: MultiCare Health System, CHI Franciscan
- Spokane: Providence Health, MultiCare Deaconess, Sacred Heart Medical Center
- Bellingham / Olympia: PeaceHealth St. Joseph, Capital Medical Center
Bottom line
Washington State offers the Pacific Northwest highest OT wages, boosted by Seattle cost of living and no state income tax. The $200 fee is offset by wages consistently 15–20% above the national median.
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