How to Become a Medical Assistant in Washington

Who can apply

• Washington requires a Department of Health credential to work as a medical assistant. DOH says that if you perform the clinical duties in RCW 18.360.050, you must hold a DOH medical assistant credential, even if you are nationally certified.
• There are five credentials: medical assistant-certified (MA-C), medical assistant-registered (MA-R), medical assistant-phlebotomist, medical assistant-hemodialysis technician, and medical assistant-EMT.
• Every credential requires a high school diploma or equivalent, answers to the personal data questions, and a background check.
• MA-C: finish an approved medical assistant program (CAAHEP or ABHES accredited, a program with at least 720 clock hours including a 160-hour externship, a 720-hour career and technical education program approved by the Office of Superintendent of Public Instruction, or a state registered apprenticeship) and either pass a recognized national exam within five years before applying or currently hold a national medical assistant certification from an approved organization.
• MA-R: no formal training or exam, but a health care practitioner must sign an endorsement attesting to your competency, and the credential is tied to that employer.
• MA-EMT: you must hold a Washington EMT, advanced EMT or paramedic certification in good standing.

Step by step

1. Choose the credential that fits your job. MA-C has the widest scope. MA-R is tied to one employer and has a narrower scope.
2. For MA-C, finish an approved medical assistant program and pass one of the recognized exams: CMA (AAMA), RMA (AMT), CCMA (NHA), NCMA (NCCT) or CCMA (AMCA). If you have met everything except the exam, you can get an interim certification for up to one year.
3. For MA-R, get hired and have your health care practitioner complete the Healthcare Practitioner Endorsement listing the tasks you are trained to do.
4. Apply to the Department of Health online through SecureAccess Washington or on paper, and pay the fee ($145 for MA-C and other certifications, $115 for MA-R).
5. If you apply for MA-R within seven days of being hired, you may work for up to 60 days while the application is processed. Phlebotomist and hemodialysis applicants who have finished training may work up to 180 days after filing.
6. Work only under the supervision of a health care practitioner, within the scope in RCW 18.360.050, and renew every two years on your birthday.

Official application →

Training and exam

Training: MA-C (WAC 246-827-0200): a medical assistant program at a school accredited by ABHES or a CAAHEP-accredited program; or a program at a school accredited by an agency the US Department of Education recognizes with at least 720 clock hours in medical assisting skills, including an externship of at least 160 hours; or a state registered apprenticeship. DOH may also approve other postsecondary education, or a career and technical education program approved by the Office of Superintendent of Public Instruction, with at least 720 clock hours covering all MA-C duties and a 160-hour externship. Military training may also count. MA-phlebotomist: a phlebotomy program at an accredited school, or a practitioner-approved training program meeting WAC 246-827-0400. MA-R: no formal training; a health care practitioner attests to your competency for each clinical task.

Exam: For MA-C you must pass one of five national exams within five years before applying: CMA (AAMA), RMA (AMT), CCMA (NHA), NCMA (NCCT) or the Clinical Medical Assistant Certification Exam (AMCA), or currently hold a national medical assistant certification from an approved organization. You do not have to keep the national certification to renew the state credential. If you have met all other MA-C requirements, an interim certification with full MA-C scope lasts until you pass the exam or one year, whichever comes first, and cannot be renewed. MA-R, MA-phlebotomist and MA-EMT do not need an exam.

What it costs in Washington

Fixed amounts are set by the state. Items marked “your quote” are priced by private sellers, so enter what you’re quoted.

How long it takes

An MA-R applicant who applies within seven days of hire may work up to 60 days while DOH processes the application. Phlebotomist and hemodialysis applicants may work up to 180 days after filing.

Keeping your credential

Renewal: Renew every two years on your birthday. DOH accepts renewal fees no sooner than 90 days before expiration. There are no continuing education requirements for any medical assistant credential. An MA-R credential ends when you leave the endorsing employer; you must tell DOH within 30 days and get a new MA-R credential with a new employer.

Good to know in Washington

What a medical assistant can do in Washington: An MA-C may take vital signs, do capillary and venous blood draws, give injections, perform EKGs, CLIA-waived and moderate complexity tests, and give medications by unit or single dose (legend drugs, vaccines and Schedule III-V controlled substances) on a written order. An MA-C may start IV lines under immediate supervision and give IV injections under direct visual supervision. An MA-R may give eye drops, topical ointments and vaccines, and give legend drugs and Schedule III-V drugs by intramuscular injection only. An MA-R may collect blood only by finger or heel stick.

Supervision: A health care practitioner (physician, PA, osteopathic physician or PA, podiatric physician, RN, ARNP, naturopathic physician or optometrist) must supervise. Supervision means the practitioner is physically present and immediately available in the facility; for blood draws, vaccines and specimen collection or diagnostic testing the practitioner must be immediately available but need not be present. During a telemedicine visit, a medical assistant helping the practitioner may be supervised by live audio and video, and an MA-C or MA-R giving intramuscular injections to treat known or suspected syphilis may be supervised by audio or video telemedicine (RCW 18.360.010). RCW 18.360.060 lists what the practitioner must decide before delegating a task. Protocols may not involve clinical judgment or medication other than vaccines.

What a medical assistant cannot do: Only an MA-C may start IVs; DOH says this is out of scope for all other medical assistant credentials even with extra IV training. An MA-R may not do phlebotomy unless also credentialed as an MA-phlebotomist. An MA-C may not do arterial blood draws or high complexity tests; that needs the MA-phlebotomist credential. An MA-C may not give Schedule II controlled substances, chemotherapy agents or experimental drugs, or any medication through a central IV line (WAC 246-827-0240).

X-ray: X-ray is not among the medical assistant duties in RCW 18.360.050. The Department of Health separately registers X-ray technicians (limited scope) under chapter 18.84 RCW and chapter 246-926 WAC: $105 application and $103 renewal every two years. Diagnostic, therapeutic and nuclear medicine work requires radiologic technologist certification instead.

Sources

• WA DOH - Medical Assistant
• WA DOH - Apply for a Medical Assistant Credential (fees, renewal)
• WA DOH - Medical Assistant Credentialing Requirements
• WA DOH - Medical Assistant Recognized Exams
• WA DOH - Medical Assistant FAQ
• RCW 18.360.050 - Authorized duties
• WAC 246-827-990 - Medical assistant fees
• WA DOH - X-Ray Technician (limited scope) registration
• WAC 246-827 - Medical assistants (246-827-0200, eff. 3/21/25)
• RCW 18.360 - Medical assistants (18.360.010, 18.360.050)
• RCW 18.360.010 - Definitions (supervision, telemedicine)