Washington Respiratory Care Practitioner License Requirements

Washington licenses respiratory care practitioners through the Department of Health under Chapter 18.89 RCW. The credential — formally called the Respiratory Care Practitioner (RCP) license — is required before anyone may practice or hold themselves out as a respiratory care practitioner in the state. Washington law is explicit: national NBRC certification alone does not authorize practice without a valid Washington license.

Washington raised its examination standard in 2022. Applicants must now satisfy both components of the NBRC Registered Respiratory Therapist credential — the therapist multiple choice examination and the clinical simulation examination. The Certified Respiratory Therapist (CRT) credential, which requires only the multiple choice component, no longer meets Washington’s initial licensure requirement for licenses issued on or after July 1, 2022. This applies to all pathways except those using the Canadian CSRT route, which has its own defined equivalency.

Applications are submitted through HELMS (the DOH Healthcare Enforcement and Licensing Management System), accessed via a Secure Access Washington (SAW) account. Paper applications remain available for applicants who cannot use the online portal. DOH does not publish a fixed processing timeline; applicants are directed to the application status webpage for current estimates.

What Makes Washington Different

A few features of Washington’s RCP licensure are worth noting for applicants coming from other states. First, Washington codified its RRT-only requirement in statute, meaning the CRT-is-sufficient model that still exists in some states is definitively off the table here. Second, Washington explicitly accommodates Canadian-trained therapists through the CSRT pathway — a provision not common across all U.S. states. Third, Washington enacted the Respiratory Care Interstate Compact (Chapter 18.91 RCW) through HB 1114 in the 2025 legislative session, making it a member of the RCIC. Verify current compact privilege availability and eligibility directly at respiratorycarecompact.org before relying on compact access for a Washington assignment.

Respiratory Care Interstate Compact (RCIC)

Washington RCP Licensure Requirements

Washington DOH recognizes four pathways to initial RCP licensure. The pathway you use determines which supporting documents you need to gather, but all applicants are subject to the same background check process and personal data questionnaire.

Pathway 1 — Approved Education and NBRC Examinations

Applicants who completed a U.S.-based respiratory therapy program must have graduated from a program accredited by CoARC, AMA/CAHEA, or CAAHEP. The program must be at minimum two years in length. In addition, applicants must have passed both the NBRC therapist multiple choice examination and the clinical simulation examination — collectively, the requirements for the RRT credential. Official transcripts must be sent directly from the issuing institution to DOH; student-issued copies are not accepted.

Pathway 2 — Current NBRC RRT Credential

Applicants holding a current, active NBRC Registered Respiratory Therapist credential in good standing may apply for Washington licensure directly on the basis of that credential. Washington DOH treats the active RRT certification as satisfying both the educational and examination requirements, provided the NBRC still recognizes the credential as meeting or exceeding Washington’s standards.

Pathway 3 — Substantially Equivalent State License

Applicants already licensed in another state may apply via the substantially equivalent state pathway. To qualify, you must: hold a license from a state DOH has determined to be substantially equivalent; have held that credential for at least two years; and have no disciplinary actions on record. Washington maintains a list of substantially equivalent states on the DOH website. Out-of-state credential verification forms must be sent directly from each prior licensing state to DOH.

Pathway 4 — Canadian CSRT Pathway

Applicants who completed at least a two-year respiratory therapy program recognized by the Canadian Society of Respiratory Therapists (CSRT) — and who have either passed the CSRT registry examination or been issued a CSRT registration — are considered by Washington to have met the educational and examination requirements. This is a distinct pathway not available in most U.S. states and reflects the geographic proximity and cross-border workforce movement between Washington and British Columbia.

How to Apply for a Washington RCP License

1. Create or log in to your Secure Access Washington (SAW) account, then add the DOH Health Professional Licensing (HELMS) service to your dashboard
2. Complete the online application, including all demographic information, personal data questions, and disclosure of any prior credentials or disciplinary history
3. Arrange for your school(s) to send official transcripts directly to DOH — student-issued or unofficial copies will not be accepted
4. If applying via the substantially equivalent state pathway, submit an Out-of-State Credential Verification form to each prior licensing state and request that they return it directly to DOH
5. Pay the application fee shown in the summary table above; payment is due at the time of application submission
6. Monitor your email — DOH communicates application status, additional requests, and approvals via email; delayed responses to DOH requests extend processing time
7. Check the DOH application status page for current processing estimates

You may not practice as a respiratory care practitioner in Washington — even with a valid license from another state — until your Washington RCP license is issued and active.

Practical Notes

• CRT holders need to upgrade before applying. If you hold only the NBRC CRT credential, you must pass the clinical simulation examination to achieve RRT status before Washington will issue you an initial license. Plan your NBRC exam timeline accordingly.
• The temporary practice permit may be an option while you wait. A temporary practice permit may be available for qualifying applicants. Verify eligibility requirements with DOH before relying on temporary authorization to practice.
• Verify compact privilege availability before counting on it. Washington enacted the RCIC, but compact privileges are subject to Commission rulemaking. Verify current privilege availability at respiratorycarecompact.org before accepting any assignment that depends on compact access rather than a full Washington license.
• Transcripts must come from the school. DOH will not accept transcripts submitted by you directly. Build in lead time for your program to mail official transcripts, particularly if your school is out of state or uses a third-party transcript service.
• Travel RTs: check the substantially equivalent states list. Washington maintains a published list of states it has evaluated as substantially equivalent. If your home state is on that list and you have held your license for at least two years with a clean record, the substantially equivalent state pathway may be faster than the standard exam pathway.

Relevant Statutes and Rules

• Chapter 18.89 RCW — Respiratory Care Practitioners — primary licensing statute
• Chapter 246-928 WAC — Respiratory Care Practitioners — administrative rules including fees and CE requirements
• Chapter 18.91 RCW — Respiratory Care Interstate Compact — Washington’s compact enactment
• Washington DOH — Respiratory Care Practitioner Laws page

Related Pages

• Washington Respiratory Care Practitioner License Renewal Guide
• Respiratory Care Practitioner Licensing by State — Complete Guide

Frequently Asked Questions

Do I need a Washington state license to practice respiratory care in Washington?

Yes. Washington law prohibits anyone from practicing or representing themselves as a respiratory care practitioner without a valid Washington RCP license. Holding a valid NBRC credential or a license from another state does not authorize practice in Washington without a Washington license. Source: Washington DOH Respiratory Care FAQ

Is the CRT credential sufficient for Washington licensure?

No. As of July 1, 2022, Washington requires applicants to pass both the therapist multiple choice examination and the clinical simulation examination — the full RRT requirement. The CRT credential, which requires only the multiple choice component, no longer satisfies Washington’s initial licensure standard for licenses issued on or after that date. Source: Washington DOH Respiratory Care FAQ

What is the application fee for a Washington RCP license?

The initial application fee is $140, nonrefundable. A temporary practice permit is available for qualifying applicants at an additional fee. Verify the current fee schedule with DOH before submitting payment. Source: Washington DOH RCP Licensing Information

Can I apply online for a Washington RCP license?

Yes. Washington DOH strongly encourages online applications through HELMS (the Healthcare Enforcement and Licensing Management System), accessed via a Secure Access Washington (SAW) account. Paper applications are also available. Online payment is accepted via credit or debit card; paper applications require a check or money order. Source: Washington DOH RCP Licensing Information

Does Washington participate in the Respiratory Care Interstate Compact?

Yes. Washington enacted the Respiratory Care Interstate Compact under Chapter 18.91 RCW (HB 1114, 2025 session). Compact implementation is administered through the RCIC Commission. Practitioners should verify current compact participation, privilege availability, and eligibility requirements directly through the Compact Commission before relying on compact practice authority in Washington. For current information, visit respiratorycarecompact.org. Source: Chapter 18.91 RCW

What are the education requirements for a Washington RCP license?

Washington requires graduation from at minimum a two-year respiratory therapy program accredited by CoARC, AMA/CAHEA, or CAAHEP. Official transcripts must be sent directly from the institution to DOH; applicants may not submit transcripts themselves. Canadian applicants may qualify through the CSRT pathway with equivalent program completion. Source: Washington DOH RCP Licensing Requirements

Is there a jurisprudence exam required in Washington?

Washington DOH respiratory care licensing requirements do not include a jurisprudence examination requirement for initial licensure. Verify with DOH directly if your application materials reference any additional testing. Source: Washington DOH RCP Licensing Requirements