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Physician Assistant Application

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Option 1: Uniform Application for Physician Assistant State Licensure (UA) and Federation Credentials Verification - -This application aims to improve license portability by eliminating the need for physician to re-enter information when applying for licenses in multiple states.

Option 2: Washington State Physician Assistant online application - for Washington State licenses only.

The Washington State Department of Health requires that only the applicant or licensee may complete an attestation for an application, or for continuing education. This is a legal attestation. Completion of the attestation by anyone other than the applicant may constitute a reportable felony offense. The Department of Health can take action against people for perjury or for making a false statement they know to be false.
For further information please see:

Washington State law authorizes the Department of Health to obtain fingerprint-based background checks for licensing purposes. This check may be through the Washington State Patrol and the Federal Bureau of Investigation. We may require this if you have lived in another state or if you have a criminal record in Washington State. This would be at your own expense.

You must pay the application fee at the time you apply. You may use a credit or debit card with a VISA or MasterCard logo, or pay by ACH/E-Check. Please make sure your address on the payment information screen matches the address your financial institution has on file for you. This fee is non-refundable. There is a convenience fee to apply online.

If we need additional documentation, we’ll notify you by email.

There are additional items you may need, in addition to your application:

If you have questions, contact our Customer Service staff at 360-236-2750.

Online Application Instructions

See the online application video.

Online application instructions are on our website. Online applications are accessed through SecureAccess Washington (SAW) security portal. You’ll need to add the Department of Health Online Application Portal service to access the online applications. The first time you add the service, you’ll be prompted to answer several questions to verify your identity. The questions will match the name and address you provide with the existing public record information. Because the questions come from public record, you need to provide a complete address and your full legal name as it appears on your driver’s license or birth certificate. You may find you have to enter a former address, especially if your address has changed recently (within the past one or two years) to get the right questions that pertain to your identity. If don’t have sufficient information in the public record to verify your identity and aren’t currently credentialed by the Department of Health, then you will need to submit a paper application, as you won’t be able to access the Online Application Portal.

Once you have completed the process you will receive an email with your pending credential number, or you can look on Provider Credential Search. Refer to this credential number any time you contact Department of Health or submit paperwork.

 

Reactivate your PA License

Physician Assistant Expired Less than 3 years (PDF)

Physician Assistant Expired over 3 years (PDF)

 

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Physician Assistant Delegation Agreement (PDF)

Physician Assistant Remote Site Request Form (PDF)

Physician Assistant Add or Change Alternate Supervisor Form (PDF)

Physician Assistant-Surgical Assistant Delegation Agreement and Guidelines (PDF)