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Washington CRNA License 2026: ARNP Requirements, Independent Practice, Salary

AH
Ava Health Team
··9 min read

Washington state grants full practice authority to CRNAs under the ARNP (Advanced Registered Nurse Practitioner) credential. No physician supervision or collaborative agreement is required by state law. Washington has also opted out of the federal Medicare physician supervision requirement for CRNAs in certified facilities, giving CRNAs full independent operating room authority statewide.

Practice Model

  • Full Practice Authority — no supervision or collaboration agreement required by state law
  • Medicare opt-out: Washington has opted out of the federal supervision requirement; CRNAs may practice without anesthesiologist direction
  • Both ACT (anesthesia care team) and CRNA-only models exist; hospital policy dictates which is used at each facility
  • Seattle's major academic centers (UW, Virginia Mason) use ACT models; rural and community hospitals predominantly rely on CRNA-only models
  • Prescribing authority included under ARNP; DEA registration required separately for controlled substance Schedule II–V

Application Requirements

  • Active Washington RN license (compact or WA-issued)
  • Current NBCRNA certification (NCE or CONTINUED COMPETENCY)
  • Official nurse anesthesia program transcript
  • Completed DOH NCQAC online application + $91 fee
  • Criminal background check

Processing Timeline

Washington DOH NCQAC processes ARNP applications in approximately 6–8 weeks from complete submission. Temporary practice authorization is not issued. Washington's online application system is among the more efficient in the country; complete applications rarely encounter significant delays.

CRNA Salary in Washington (2026)

MarketAvg CRNA SalaryNotes
Seattle / King County$225,000–$255,000UW Medicine, Virginia Mason, Swedish; tech-sector COL premium
Tacoma / Pierce County$210,000–$240,000MultiCare Health, CHI Franciscan; lower COL than Seattle
Spokane$200,000–$228,000Providence Sacred Heart, MultiCare Deaconess
Bellingham / Everett$205,000–$235,000PeaceHealth, Providence Regional; travel CRNA positions common
Rural / CAH facilities$215,000–$250,000Critical Access Hospitals; CRNA-only model; signing bonuses common

Top Employers in Washington

  • UW Medicine — Seattle; academic ACT model; training programs; competitive total comp
  • Virginia Mason / CHI Franciscan — Seattle/Tacoma; merged system; active CRNA hiring
  • Providence Health & Services — Spokane, Eastern WA; CRNA-only model in rural facilities
  • MultiCare Health System — Tacoma/Spokane; community-focused anesthesia model
  • PeaceHealth — Bellingham; Northwest WA; CRNA-independent model

What We See at Ava Health

Washington is one of the top CRNA markets in the Pacific Northwest. Seattle salaries are among the highest nationally, though the cost of living — particularly housing — significantly offsets the nominal premium. Eastern Washington (Spokane, Yakima, Tri-Cities) offers strong CRNA compensation with materially lower cost of living and persistent rural demand.

Related: CRNA License California 2026, CRNA Salary by State 2026, NP License Washington 2026.

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