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Telehealth nursing license requirements in Washington

Telehealth licensing has one governing idea: you generally need authority where the patient is. Here is how that plays out for patients located in Washington.

Do I need a Washington license for telehealth nursing?

Generally, you need authority to practice where your patient is — so if your patient is in Washington, Washington licensure rules apply, even if you never leave home. Because Washington recognizes compact privilege, an active multistate license from your compact home state generally covers telehealth to patients in Washington. A single-state license does not. Employer policy and the Washington State Board of Nursing (WABON)’s rules may add requirements on top — confirm before you take the role.

Last reviewed 2026-06-17

Licensure follows the patient

The location that matters for telehealth is generally the patient’s, not yours. Sitting in one state and caring for a patient in Washington generally means you need authority to practice in Washington — via compact privilege or a Washington license. See telehealth: patient in another state.

The law that governs this in Washington

Caring for a patient located in Washington is practice in Washington, so it is Washington’s own nurse practice act that defines what you may do and the Washington State Board of Nursing (WABON) that applies it. That act is RCW ch. 18.79 (Nursing Care).

The compact itself is separate law. Washington adopted it at Substitute Senate Bill 5499 (2023), which is what allows a multistate license issued elsewhere to reach Washington at all — the practice act still decides what you may do once it does.

Compact status is not the only consideration

Even where a multistate license reaches Washington, your employer and the Washington State Board of Nursing (WABON) may impose additional requirements, and some roles carry their own rules. Compact status answers one question — it is not a blanket authorization to practice remotely.

APRN telehealth is separate

The compact covers RN and LPN/LVN licenses only. If you work as an APRN, your advanced-practice authority is granted state by state and is not carried by a multistate RN license — a point that catches out a lot of remote NP roles.

Since when has a compact license worked in Washington?

Nurses holding another state’s multistate license have been able to practice in Washington since July 24, 2023. That is recent enough that employer handbooks, agency briefings, and articles written before then still describe Washington as non-compact — so if you are told you need a Washington license, check the date on the guidance.

Note the asymmetry: Washington opened to visiting nurses on that date but did not begin issuing multistate licenses to its own residents until January 31, 2024. If you are caring for patients located in Washington while living elsewhere, the earlier date is the one that applies to you. If you move to Washington, the later one does.

What usually comes next

Next-step checklist

  • Identify where your patients are located — that generally drives licensure.
  • Confirm your license reads multistate on Nursys (nursys.com) if you rely on privilege.
  • Confirm your multistate license covers Washington, then check employer requirements.
  • If you practice as an APRN, confirm Washington APRN authority separately with the board.

Frequently asked questions

Generally, if you hold an active multistate license from your compact home state, compact privilege reaches Washington, which covers telehealth to patients located in Washington. Licensure follows the patient's location. A single-state license does not carry privilege. Employer and board rules may add requirements — confirm with the Washington State Board of Nursing (WABON).

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