Who can inject
MD, DO, NP, PA, RN under physician supervision/delegation
Registered nurses (RNs)
Yes, under physician delegation and supervision
Nurse practitioners & physician assistants
NP/PA may inject under physician collaboration; independent practice limited
The exam that makes it legal
Required; in-person or telehealth allowed under physician discretion A valid order or good-faith exam by an authorized provider is what makes an injection lawful — not simply who holds the syringe.
Training expected
No state-mandated injector training beyond licensure.
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.