Who can inject
MD, DO, NP, PA, RN under physician supervision/delegation
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
The exam that makes it legal
Required; in-person or telehealth allowed under certain conditions A valid order or good-faith exam by an authorized provider is what makes an injection lawful — not simply who holds the syringe.
Training expected
No state-mandated injector training beyond licensure.
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.