How to Get Your Dental Hygienist License in Washington (2026)

How to Become a Registered Dental Hygienist in Washington State

Washington State is one of the most desirable destinations for dental hygienists in the country. The Seattle-Puget Sound corridor consistently ranks among the top markets for RDH compensation in the nation, and Washington has expanded its scope of practice with the Expanded Practice Dental Hygienist (EPDH) credential, allowing qualified hygienists to serve underserved communities in schools, nursing homes, and community health settings without direct supervision. Licensure is governed by the Dental Quality Assurance Commission (DQAC) within the Washington State Department of Health (DOH).

Step 1: Complete an Accredited Dental Hygiene Program

You must graduate from a dental hygiene program accredited by the Commission on Dental Accreditation (CODA). Washington has excellent in-state program options:

• University of Washington School of Dentistry (Seattle), bachelor's and graduate programs
• Shoreline Community College (Shoreline)
• Bellingham Technical College
• Pierce College (Lakewood)
• Columbia Basin College (Pasco)

CODA accreditation is mandatory. Verify accreditation status directly on CODA's website before enrolling. Both associate degree (AAS) and bachelor of science (BS) graduates are eligible for Washington State licensure.

Step 2: Pass the NBDHE

The National Board Dental Hygiene Examination (NBDHE) is required by the DQAC. Administered by the Joint Commission on National Dental Examinations, the NBDHE is a thorough written exam covering dental hygiene science and clinical case studies.

• Minimum passing score: 75 (scale 49-99)
• Format: Computer-based, available at Prometric testing centers
• Timing: Most candidates sit during their final semester or within 12 months of graduation

Washington allows you to submit your license application before NBDHE results are received (in some cases), but verify current processing procedures with the DOH at the time of application.

Step 3: Pass a Clinical Examination

Washington State accepts both the WREB (Western Regional Examining Board) and ADEX (American Board of Dental Examiners) dental hygiene clinical examinations. The WREB was historically the dominant exam in western states; ADEX acceptance was added to give candidates more flexibility.

Both are patient-based clinical examinations evaluating your proficiency in:

• Periodontal assessment and charting
• Scaling and root planing (supragingival and subgingival)
• Radiographic evaluation and infection control

Schedule early, WREB test dates at Washington sites book up quickly, particularly for spring dates. Out-of-state testing is an option if local slots are unavailable.

Step 4: Apply for Your State License

After securing passing scores on both the NBDHE and a clinical exam, apply through the Washington State Department of Health Professions Licensing portal. Key details for 2026:

• Regulatory body: Dental Quality Assurance Commission (DQAC), Washington State Department of Health
• Application fee: Approximately $100-$175 (verify the current fee at doh.wa.gov)
• Required documents: Completed online application, official NBDHE transcript, official clinical exam score report, official transcript from a CODA-accredited program, and criminal history disclosure

Washington requires a Washington State Dental Hygiene Jurisprudence exam (an online exam on WA dental law and rules) as part of licensure. This can typically be completed through the DOH's licensing portal or via an approved CE provider.

Continuing Education Requirements

Washington operates on a three-year renewal cycle, which is distinct from most states that use a two-year cycle. The requirement is 21 CE hours per three-year renewal period, with mandatory topics within that total:

• 7 mandatory CE hours in topics designated by the DQAC (which may include topics such as infection control, patient safety, or opioid/pain management, verify current mandatory topic requirements with the DOH before each renewal)
• 14 elective hours from DQAC-approved CE providers

The three-year cycle means less frequent renewal paperwork, but the mandatory topic requirements add complexity. Build a CE tracking system early in your career.

Expanded Practice Dental Hygienist (EPDH) Credential

Washington is one of the leading states for expanded dental hygiene practice. The Expanded Practice Dental Hygienist (EPDH) credential allows licensed RDHs who meet additional requirements to provide dental hygiene services in underserved settings, including schools, Head Start programs, nursing facilities, and community health centers, without the direct supervision of a dentist present.

EPDH requirements include additional education hours, a clinical competency demonstration, and specific continuing education on public health and community-based care. If you are interested in community or public health dentistry, Washington's EPDH credential is one of the strongest in the country.

Washington Dental Hygienist Salary Ranges

Washington State, and Seattle in particular, is among the highest-paying markets for dental hygienists in the United States:

• Seattle / King County: $85,000-$105,000/year for experienced full-time RDHs, driven by high cost of living, strong tech-sector dental benefits, and a tight labor market
• Tacoma / Pierce County: $78,000-$92,000/year
• Spokane / Eastern Washington: $68,000-$80,000/year
• Rural Washington / EPDH community health settings: $62,000-$76,000/year base, with potential loan repayment through NHSC or Washington's State Loan Repayment Program
• Per-diem: $48-$68/hour in the Seattle metro, among the highest per-diem rates in the country

Top Employers for Dental Hygienists in Washington

• University of Washington School of Dentistry (Seattle), major academic employer; also employs hygienists in its faculty practice
• Seattle Children's Hospital, dental program for pediatric patients
• Kaiser Permanente Washington, large integrated health system with dental care
• Community Health Centers of King County, Sea Mar Community Health Centers, FQHC employers for community-practice-focused RDHs and EPDH credential holders
• Willamette Dental Group, large Pacific Northwest DSO with Washington locations
• Aspen Dental, Pacific Dental Services, Heartland Dental, DSO group practices across the state
• Private practices throughout Seattle, Bellevue, Redmond, Tacoma, and Spokane