Can registered nurses and nurse practitioners inject Botox and fillers in Washington?

Yes, under physician delegation and supervision NP/PA may inject under physician collaboration; independent practice limited

Washington · Moderate

Can RNs and Nurse Practitioners Inject Botox in Washington?

Nurses do most of the injecting in this industry — but Washington draws specific lines around what an RN versus an NP can do, and who has to supervise.

By Evan at Inside MedSpa

Registered nurses (RNs)

Yes, under physician delegation and supervision

Nurse practitioners & physician assistants

NP/PA may inject under physician collaboration; independent practice limited

Supervision & the medical director

Required for medical spa operations

The exam requirement

Required; in-person or telehealth allowed under physician discretion

What to verify in Washington

Verify that your medical director holds an active Washington medical license and establish clear written delegation agreements for all injectors.

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.

See the full Washington regulation profile →

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