CRNA · Washington

Collaborative Practice Agreement for Certified Registered Nurse Anesthetists in Washington

No. Certified Registered Nurse Anesthetists practice independently here. Washington does not require one.

Practice authorityIndependent practice
Written agreementNo agreement required
What Washington calls itNo instrument required
Research date2026-09-03

CRNAs are one of Washington's four ARNP roles under RCW 18.79 and are licensed independent practitioners exactly like NP/CNM/CNS — no physician supervision or agreement required, unlike states (e.g. UT) that carve CRNAs out of prescriptive authority or independence.

What the collaboration must look like

The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.

Proximity

No proximity requirement

No physician-oversight relationship exists — ARNP-CRNAs are licensed independent practitioners under WAC 246-840-300.

Supervision ratio

Not codified — no cap on file

Chart review

Not codified — left to the agreement

Meeting cadence

Not codified — left to the agreement

Prescriptive authority

Covered by the practice agreement · controlled substances permitted

Schedule II-V upon Board of Nursing prescriptive-authority approval (RCW 18.79.240), same as other ARNP roles; Schedule I excluded.

Written agreement

Not required

Unconditional — Washington does not require a physician agreement for CRNAs.

Practice ownership (corporate practice of medicine)

Licensee-only ownership required — Professional Service Corporation under RCW 18.100.050 — CRNAs are among the 12 enumerated health professions eligible to co-own a multi-discipline PSC; non-licensees may not hold equity.

Legal sources for these rules (2)

What a collaborating physician costs here

Typical monthly cost in Washington

$500$600

Estimate for one Certified Registered Nurse Anesthetist. Standard-tier state.

About Washington's rules

Washington is a full-independence state for ALL FOUR ARNP roles (NP, CRNA, CNM, CNS) under RCW 18.79, not just NPs — confirmed current via WAC 246-840-300/420 and Board of Nursing guidance. PAs are separate: HB 2041 (eff. Jan. 1, 2025) replaced supervision-only with a 4,000-hour supervision→collaboration tier (RCW 18.71A.120) with no numeric ratio cap.

Other clinicians in Washington: see the state overview.