ava health

Healthcare Recruiting

Washington PA License 2026: Physician Assistant Requirements, OTP Authority, and Salary

AH
Ava Health Team
··8 min read

Washington State physician assistants practice under Optimal Team Practice (OTP) — no mandatory supervision agreement filing with the Washington Medical Commission. Seattle is anchored by UW Medicine, Providence, MultiCare, and Virginia Mason Franciscan Health — four of the largest integrated health systems in the Pacific Northwest. Washington has no state income tax, amplifying net compensation across all markets.

Practice Model: Optimal Team Practice (OTP)

  • No supervision agreement required to be filed with the Washington Medical Commission
  • Collaborative practice determined at the employer/practice level
  • Prescriptive authority for Schedule II–V included (DEA registration required separately)
  • No state income tax — significant net compensation advantage over comparable California and Oregon positions

Application Requirements

  • Active NCCPA certification
  • Accredited PA program graduation verification
  • Background check via WMC
  • Application fee ~$400

Processing Timeline

6–8 weeks typical; approximately 8 weeks total with concurrent DEA.

PA Salary in Washington State (2026)

SettingMedian BaseTypical Sign-On
Hospital / Inpatient (Seattle)$134,000$10,000–$22,000
Hospital / Inpatient (Spokane / Tacoma)$122,000$8,000–$18,000
Surgical First-Assist$142,000$12,000–$25,000
Primary Care / FQHC (rural eastern WA)$115,000$8,000–$15,000 + loan repayment

Top PA Employers in Washington

UW Medicine (Seattle academic flagship — Harborview Level I trauma, UW Medical Center), Providence Health & Services (statewide — 12 WA hospitals), MultiCare Health System (Tacoma-based, 12 hospitals), Virginia Mason Franciscan Health (Seattle and Tacoma), and Providence Sacred Heart / MultiCare Deaconess (Spokane) anchor the eastern market. Rural eastern Washington and the Olympic Peninsula carry HPSA loan repayment eligibility.

What We See at Ava Health

Washington's combination of OTP authority, no income tax, and Seattle's high base salaries makes it one of the most financially attractive PA markets nationally. Harborview's trauma program is a top destination for acute care PAs. Spokane and the Columbia Basin offer lower COL with strong system employment and rural loan repayment stacking.

Related: NP License Washington 2026, PA Salary by State 2026, Healthcare Recruiting in Washington 2026.

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