Becoming an Advanced Registered Nurse Practitioner (ARNP) in Washington State represents a significant career advancement, moving into a role with increased autonomy and specialized clinical focus. The Nurse Practitioner (NP) role involves taking comprehensive patient histories, performing physical examinations, diagnosing and managing acute and chronic illnesses, and providing health promotion counseling across the lifespan. This profession is experiencing rapid growth, with the U.S. Bureau of Labor Statistics projecting a 45% increase in roles nationwide between 2022 and 2032. In Washington, the average annual salary for ARNPs often exceeds $145,000.
Laying the Foundation: Becoming a Registered Nurse
The journey to becoming an Advanced Registered Nurse Practitioner must first begin with securing a license as a Registered Nurse (RN). Prospective ARNPs typically complete either an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN) program, though a BSN is generally required for advanced degree programs. Upon graduation, the candidate must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to qualify for state licensure.
Gaining initial licensure in Washington is handled by the state’s licensing body. Candidates who are already licensed in another state can apply for a Washington RN license by endorsement, a process that requires verification of the original license through the Nursys system. The applicant must submit an online application through the SecureAccess Washington (SAW) portal and pay the required fee, which is currently set at $138. A criminal history background check, which involves submitting fingerprints for review, is also a mandatory part of the initial licensing requirement.
Advanced Education Requirements
The next phase requires the completion of an advanced nursing degree, either a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP). Washington State requires that this graduate-level education be obtained from a program accredited by a national nursing accreditation body recognized by the U.S. Department of Education. The program curriculum must include distinct coursework in advanced physiology, advanced health assessment, and advanced pharmacology.
These programs are structured to prepare the NP for a specific population focus, which dictates the scope of future practice. Common specialties include Family Nurse Practitioner (FNP), Pediatric Nurse Practitioner (PNP), and Psychiatric-Mental Health Nurse Practitioner (PMHNP). The educational experience must include a significant clinical component, with state requirements mandating no fewer than 500 hours of direct patient care under the supervision of a clinical preceptor and faculty oversight. To qualify for prescriptive authority, the program must incorporate at least 30 contact hours of education in pharmacotherapeutics within the two years prior to applying for the ARNP license.
National Certification and Examination
After successfully completing the graduate program, the candidate must pass a national certification examination in their chosen population focus. This national certification is a prerequisite for state licensure. The two primary certifying bodies are the American Academy of Nurse Practitioners Certification Board (AANPCB) and the American Nurses Credentialing Center (ANCC).
The choice of certifying body often depends on the candidate’s desired focus, as the exams have slightly different orientations. The AANPCB exam generally centers on clinical knowledge and the practical application of patient care, testing core competencies like assessment, diagnosis, and planning. The ANCC exam includes a broader scope, incorporating questions on professional role, ethics, and healthcare policy, in addition to clinical content. The certification must be active in the specific area of practice, such as Adult-Gerontology Primary Care or Women’s Health, before the state will consider the application for ARNP licensure.
Applying for Washington State Licensure
Once the educational and national certification requirements are met, the candidate applies for the Advanced Registered Nurse Practitioner (ARNP) license through the Washington State Nursing Care Quality Assurance Commission (NCQAC). This process begins with an online application submitted via the SecureAccess Washington (SAW) portal and the payment of the required application fee. The state requires several pieces of documentation to be submitted directly to the Commission to verify eligibility:
- Official graduate degree transcripts, showing the degree conferred and the graduation date, must be sent directly from the educational institution.
- Proof of current national certification must be submitted directly from the certifying body to the Commission.
- All applicants must complete a one-time, seven-hour course in HIV/AIDS training, which is a state-specific requirement.
- ARNPs who graduated more than one year prior to applying for initial licensure must provide proof of at least 250 hours of practice within the last two years.
Understanding Washington State Scope of Practice
Washington State operates under a Full Practice Authority (FPA) model for advanced practice nursing. This legal framework grants ARNPs the authority to practice to the full extent of their education and national certification without requiring supervision, collaborative agreement, or oversight from a physician. ARNPs are empowered to assess, diagnose, order and interpret diagnostic tests, and formulate comprehensive treatment plans independently.
The FPA status includes full prescriptive authority, allowing ARNPs to prescribe medications, including controlled substances, provided they register with the Drug Enforcement Administration (DEA). The legal foundation for this independent practice is outlined in the Revised Code of Washington (RCW) 18.79. This autonomy allows ARNPs to function as independent primary care providers, increasing access to care in rural and underserved areas of the state. Although not a state requirement for licensure, ARNPs who enroll in certain provider networks must secure professional liability coverage.
Maintaining Licensure and Continued Competency
Maintaining the ARNP license in Washington requires biennial renewal, which must be completed by the practitioner’s birthday every two years. The ARNP must hold an active Washington RN license or a multistate RN license from a compact state throughout the renewal cycle. A primary component of continued competency is the requirement to maintain active national certification in the specialty area.
For each two-year renewal cycle, ARNPs must attest to completing 30 contact hours of continuing education (CE) in their area of specialty. ARNPs who hold prescriptive authority must complete an additional 15 contact hours of CE specifically related to pharmacotherapeutics, bringing the total to 45 hours. All ARNPs must also complete a one-time, six-hour training course on suicide assessment, treatment, and management.