Registered nurses (RNs)
Yes, under physician delegation; on-site presence may vary
Nurse practitioners & physician assistants
NP/PA may inject under physician collaboration; independent practice limited
Supervision & the medical director
Required for facilities with RN/LPN injectors
The exam requirement
Required; in-person or telehealth allowed under certain conditions
What to verify in Washington
Establish a clear physician delegation agreement and verify telehealth GFE protocols with the Washington Medical Commission before launch.
Primary source: Washington Medical Commission; Washington Nursing Care Quality Assurance Commission
General business information for Washington medical-spa owners, current as of 2026 — not legal advice. State boards update rules often; confirm specifics with the Washington board (and your own counsel) before you act.