How to get a Nursing Assistant-Certified license in Washington

Washington nursing assistant licenses

Washington issues 3 nursing assistant credentials. Each has its own section below; the table shows what each one covers and its headline requirements.

Applies to every license level

These rules are the same for several of the Washington nursing assistant licenses on this page, so they are shown once here, with the licenses they apply to. Each license's own section lists only what differs.

1. Every license level (all 3)

Requirements

Background check

Background check required⁴
No fingerprints required⁴
Answer the personal data questions in the application; any "yes" answer needs supporting documents such as certified court records and a written statement. Applicants are subject to the denial grounds in chapter 18.130 RCW (Uniform Disciplinary Act).⁶

How to apply

Apply online

nursing.wa.gov⁶

Renewal

How often

Every year⁵²

Renew online

nursing.wa.gov⁵

2. Every license level except Medication Assistant Certification Endorsement (MACE) on a Nursing Assistant-Certified credential

Fees

Each line is a separate charge as the board lists it. The board does not publish a combined total, so none is shown here.

Renewal

Renewal fee

$95²

Who needs a Nursing Assistant-Certified license

Assists in patient care as delegated by and under the direction and supervision of an RN or LPN, in nursing homes, hospitals, hospice and home health agencies and other settings with licensed-nurse supervision. Certification is mandatory in nursing homes and voluntary elsewhere unless another law requires it. Nursing assistants may not give injections (except insulin under RN delegation), do sterile procedures or acts requiring nursing judgment.¹

Other rules on who may do this work:

• Outside nursing homes, certification is voluntary (a nursing assistant-registered may work there) unless state or federal law requires certification.¹

Requirements for a Nursing Assistant-Certified license

More rules for this license are shared with other levels: group 1 and group 2 under Applies to every license level.

Education or training

At least 108 clock hours²
Complete a Board-approved traditional nursing assistant training program: at least 108 hours (at least 35 classroom theory, 33 skills lab and 40 clinical), using the Board's common curriculum. Facility orientation does not count toward clinical hours.²
Who may teach it: Programs must be approved by the Washington State Board of Nursing (community and technical college and high school programs in cooperation with the SBCTC or OSPI).¹
Alternative: Home Care Aide bridge: a Washington certified home care aide (HCA-C) can take a 36-hour alternative program (17 classroom, 13 skills lab, 6 clinical) plus CPR, then the state exams.²
Alternative: Medical Assistant bridge: a Washington medical assistant-certified can take a 36-hour alternative program (16 classroom, 14 skills lab) plus adult CPR, then the state exams.²
Alternative: Nursing students: many qualify after their first quarter; send official transcripts and a current CPR card for review, then take the state exams.⁶
Alternative: Out-of-state or out-of-country training (not certified elsewhere): send transcripts or a certificate of completion and a current CPR card; if approved, take the Washington exams.⁶
Alternative: Military training: submit a DD214 (or NGB-22) and Joint Services or CCAF transcripts; military training counts unless the Board finds it not substantially equivalent.¹
Alternative: Nursing-assistant-registered work pathway: with the program's permission, a student may earn the clinical hours by working as a nursing assistant-registered under licensed-nurse supervision after finishing classroom and skills lab.²

Exam

Washington Nursing Assistant Certification exam: in-person skills test and online (or oral) knowledge test (NNAAP knowledge test via Credentia)³
Given by: Credentia (knowledge test); skills test given by the training program or arranged by WABON⁶
When you can take it: Skills test after finishing theory, skills lab and clinical; register for the knowledge test after passing the skills test, using your pending NAC credential number (so apply to WABON while still in training).⁴
Part 1: in-person skills test³
Part 2: online knowledge test (oral version available)¹
Retakes: Up to four attempts at each part: after failing the skills test or the knowledge test four times you must retrain. OBRA reactivation candidates get only one retest.⁴
Exam waived: Applicants certified in another state with substantially equivalent standards can be certified by endorsement without the competency evaluation.¹

Also required

Nurse delegation in community or in-home settings needs DSHS nurse delegation core training (and the diabetes special-focus course for insulin).²

How much a Nursing Assistant-Certified license costs

How to apply

1. Choose your pathway (traditional program, HCA or MA bridge, endorsement, nursing student, out-of-state, military or out-of-country training) and complete the approved training.⁶
2. While still in training, create a SecureAccess Washington account, add the DOH HELMS service and submit the NAC application.⁶ secureaccess.wa.gov⁴
3. Pay the $85 application fee online and upload documents for your pathway (and court records for any "yes" answer). You get an email with a pending credential number.⁶
4. Take the skills test (through your program, or email [email protected] for non-routine routes), then register with Credentia for the knowledge test using your pending credential number.⁴
5. The credential is issued once WABON receives the last requirement; you are added to the OBRA registry. Check status on Provider Credential Search.⁴ fortress.wa.gov⁸

Renewal and continuing education

When it expires

Renew every year by your birthday in HELMS. A first credential issued within 90 days of your birthday runs to the following birthday. Renewal fees are accepted up to 90 days early. Once certified you no longer need to renew your NAR.²

Late renewal

Late renewal fee: $50² (renewal after the birthday expiration date (less than 1 year late))
Reinstatement fee: $52² (reactivation more than 1 year after the renewal due date)

If it expires

Expired less than a year: renew late in HELMS ($95 + $50). More than a year: file a reactivation application ($197 total); there is no grace period and the next renewal is still due on your birthday. Expired more than 3 years with no active license in another state: complete a new training program and retest.⁵

Moving to Washington with a license from another state

These are the routes WABON publishes for the Nursing Assistant-Certified license. The other nursing assistant licenses have their own routes in their sections below.

Military service members, veterans and spouses: Military nursing-assistant training satisfies Washington's training requirement unless the Board finds it not substantially equivalent; apply with a DD214 or NGB-22 and JST/CCAF transcripts, then take the state exams.¹

Medication Assistant Certification Endorsement (MACE) on a Nursing Assistant-Certified credential

In nursing homes only, under direct supervision of a designated RN: give OTC and most legend drugs, Schedule IV-V medications orally, topically or by inhalation, and simple treatments (blood glucose monitoring, clean dressing changes, pulse oximetry, oxygen). No injections, tube medications, PRN medications, Schedule I-III handling, sterile tasks or dose calculations.²

Requirements

Education or training

At least 100 clock hours²
Complete a Board-approved medication assistant training program (NCSBN Medication Assistant-Certified model curriculum) within the year before applying: at least 100 hours (50 classroom, 10 skills lab, 40 supervised clinical in a nursing home). No online or NAR-work options.²
Who may teach it: Program must be a Board-approved NAC training program or nursing education program in good standing, taught by Washington RNs.²

Experience

At least 1,000 hours of on-the-job training⁶
At least 1,000 hours of work as a nursing assistant-certified in a nursing home in the year before applying, verified by the nursing home HR department on the WABON form.¹⁰
License you must hold first: Washington NAC in good standing.²

Exam

Washington MACE exam (written knowledge exam; skills are evaluated by the training program)²
Given by: Credentia¹¹
When you can take it: After training and the 1,000 hours: apply for the endorsement in HELMS with the certificate of completion and work verification; WABON emails an Authorization to Test, then you register with Credentia.¹¹
Written knowledge exam⁶
Exam waived: Medication assistants credentialed in another state may qualify with written verification of a substantially equivalent credential, equivalent education and the 1,000-hour work documentation.²

Social Security number

The MACE work-experience form asks for your Social Security Number.¹⁰

Fees

The board's pages we cite do not list the exam fee; check it with the exam provider, Credentia¹¹, when you schedule.

How to apply

1. Hold a Washington NAC, work 1,000 hours in a nursing home and complete an approved MACE program within the past year.²
2. Apply for the endorsement in HELMS, pay $25 and upload the certificate of completion and the nursing home's work-experience verification.⁶ Form (PDF, nursing.wa.gov)¹⁰
3. Receive the Authorization to Test by email and register with Credentia for the MACE exam.¹¹

Renewal

When it expires

Renew yearly with your NAC (birthday). Each year you need employer documentation of 250 hours as a medication assistant in a nursing home under RN supervision and 8 hours of medication-related CE.²

Renewal fee

$10⁷

Continuing education

At least 8 hours each renewal period²

Required topics

Medications, medication administration and selected patient treatments (8 hours/year) plus 250 hours of medication-assistant work.⁵

Approved courses

Board-approved medication training programs, programs approved by a professional association, or nursing-home staff development programs.²

If it expires

The endorsement can only be renewed while the NAC is current and in good standing; the WABON fee table shows no separate late or reactivation fee for the endorsement.²

From another state

More rules for this license are shared with other levels: group 1 under Applies to every license level.

Nursing Assistant-Registered

Same nursing-assistant role under RN/LPN delegation and supervision, but a facility may not assign care until the NAR has shown competence in the assigned duties. In nursing homes an NAR has four months to become certified.¹

Requirements

Education or training

No prior training required.⁶

Also required

Apply within three days of being hired (nursing-home students must apply within three days of hire).¹

Also required

Before doing delegated tasks in community-based or in-home settings, an NAR needs DSHS basic caregiver training and nurse delegation core training.²

How to apply

1. Complete the online NAR application in the HELMS portal (SecureAccess Washington).⁶ secureaccess.wa.gov⁴
2. Pay the $85 application fee online.⁶
3. Upload any required documents (court records and statements for "yes" answers) and submit; you receive a pending credential number by email.⁶

Renewal

When it expires

Renew every year by your birthday in HELMS; not needed once you hold an active NAC. Renewal fees are non-transferable and non-refundable.⁵

Late renewal

Late renewal fee: $50² (less than 1 year late)
Reinstatement fee: $52² (more than 1 year late (reactivation))

If it expires

More than one year after the due date, submit a reactivation application with the fee in HELMS; you still owe the next renewal on your birthday (no grace period).⁵

From another state

More rules for this license are shared with other levels: group 1 and group 2 under Applies to every license level.

City and county rules

Medication Assistant Certification Endorsement (MACE) on a Nursing Assistant-Certified credentialNo local license: statewide Washington State Board of Nursing credential.¹

Check a license or report a problem

Before you hire a nursing assistant in Washington, you can confirm the license is current on the board's own search. Every board we cover in Washington is on the Washington license lookup page.

Look up a license

fortress.wa.gov⁸

File a complaint

nursing.wa.gov¹²

Laws and rules

The requirements above come from these laws and board rules.

• RCW 18.88A (Nursing assistants), as amended by 2025 c 5 (SB 5051) and 2025 c 58
• WAC 246-841A Nursing assistants (amended by WSR 26-13-119, effective 7/1/26)
• WAC 246-841A-990 Nursing assistant — Fees and renewal cycle
• WAC 246-12-020 through 246-12-051 (initial credential, renewal, expired credentials, temporary practice permit)
• RCW 18.88A.082 Medication assistant endorsement
• WAC 246-841A-586 through 246-841A-595

Common questions

Certified nursing assistant (CNA) licenses in other states

• Alabama
• Alaska
• Arizona
• Arkansas
• California
• Colorado
• Connecticut
• Delaware
• District of Columbia
• Florida
• Georgia
• Hawaii
• Idaho
• Illinois
• Iowa
• Kentucky
• Louisiana
• Maine
• Maryland
• Massachusetts
• Michigan
• Minnesota
• Mississippi
• Missouri
• Montana
• Nebraska
• Nevada
• New Hampshire
• New Jersey
• New Mexico
• New York
• North Carolina
• North Dakota
• Ohio
• Oklahoma
• Oregon
• Pennsylvania
• Rhode Island
• South Carolina
• South Dakota
• Texas
• Utah
• Virginia
• West Virginia
• Wyoming