How long does a Washington medical license take?

The Medical Commission averaged 41.8 days to issue a license in fiscal year 2025, across its license types, and says review and approval of a complete file take under 14 days for 99% of its applicants; its FAQ puts average processing at up to 12 weeks. The osteopathic board publishes no processing time of its own: on October 22, 2026, the Department of Health listed September 9, 2026 as the oldest application date for the group that includes DO applications, and the board asks for a complete file at least 60 days before you start work. On the compact route, IMLCC’s Year 9 averages were 38 days from application to a Letter of Qualification, then 22 days from qualification to issued licenses.

How much does a Washington medical license cost?

About $617 for an MD and $492 for a DO applying from out of state: the $511 or $391 application fee, a $70 USMLE or $65 COMLEX transcript, and the $36 federal background check, plus a local fingerprinting fee no agency publishes. A DO who took the USMLE pays about $497. Through the IMLC, compact fees are $1,211 for an MD or $1,111 for a DO.

Is Washington in the IMLC?

Yes. Washington’s compact law took effect July 23, 2017; both boards issue licenses through it, and either can be your state of principal license. In IMLCC’s Year 9, April 2025 to March 2026, the Medical Commission issued 538 licenses through the compact and the osteopathic board issued 90.

Is the IMLC or a direct application cheaper for Washington?

In published fees, a direct application: about $617 for an MD or $492 for a DO from out of state, against $1,211 or $1,111 through the compact. The compact can still make sense when you meet its terms and are adding other member states, since IMLCC’s $700 covers one application and each state adds its own fee; adding Washington to a Letter of Qualification still within its 365 days costs $611 for an MD or $511 for a DO. The compact also requires specialty certification, which a direct Washington license does not.

Do MDs and DOs apply to the same board?

No. MDs apply to the Washington Medical Commission and DOs to the Board of Osteopathic Medicine and Surgery, under separate laws and fees: $511 to apply as an MD against $391 as a DO, and $996 every two years against $461 every year to renew. State law bars the commission from licensing a DO.

Does Washington require fingerprints or a jurisprudence exam?

Fingerprints, yes, if you apply from out of state; a jurisprudence exam, no. The Department of Health runs a national fingerprint check on out-of-state applicants once it notifies them, at $36 plus the local cost of taking the prints, and neither board requires a state law exam or an interview.

Can I start practicing before the full Washington license issues?

Sometimes, with a temporary practice permit. MDs with an active, unrestricted license in a state on the commission’s recognized list, 15 states for US and Canadian graduates after July 28, 1985, can request a 90-day permit for $50 with the full application, and MDs whose file is complete except the national background check result can practice under a 6-month permit, extendable once by 6 months. DOs licensed in a substantially equivalent state can request a single 180-day permit for $70, though the board says verifying the other state’s standards can take longer than the full application.

Is FCVS required in Washington?

No. Both boards accept FCVS and neither requires it; the osteopathic board takes FCVS core documents for your school, training, and exam records but still wants every state verification.

What does staying licensed in Washington involve?

Renewal on your birthday, every two years for MDs ($996) and every year for DOs ($461); 200 CME hours every four years for MDs or 150 every three years for DOs, with one-time suicide prevention and opioid trainings and 2 health equity hours every four years; prescription monitoring registration and queries for opioid prescribing; and a separate $888 DEA registration for Washington. Washington has no state controlled-substance registration.

Washington physician license: fees, timeline, requirements, and common delays

Q: Do I need a Washington license to treat Washington patients by telehealth?

Yes, apart from narrow exceptions. Washington’s telehealth law lets a physician licensed elsewhere consult with a Washington practitioner who stays responsible for the patient, give a specialty assessment or recommendation without treating, or provide continuity-of-care follow-up to an established patient who is temporarily in Washington; other telehealth to patients located in Washington needs a Washington license, issued directly or through the IMLC.

Washington licenses MD and DO physicians through two boards, the Washington Medical Commission and the Board of Osteopathic Medicine and Surgery, and both issue licenses directly or through the IMLC. Applying from out of state, budget about $617 for an MD and $492 for a DO in application, transcript, and federal background check fees, plus the local cost of taking your prints; compact fees are $1,211 for an MD or $1,111 for a DO. The Medical Commission averaged 41.8 days to issue a license in fiscal year 2025, across its license types; the osteopathic board publishes no processing time of its own. The friction is the FBI fingerprint check, which the commission calls the longest part of the process.

Washington at a glance.

License: Physician and surgeon license (MD); osteopathic physician and surgeon license (DO)
MD and DO: Two boards: the Medical Commission for MDs, the osteopathic board for DOs
IMLC: Member state, issuing licenses. Washington can be your state of principal license, MD or DO; compact law in force since July 23, 2017
FCVS: Accepted by both boards, required by neither
Uniform Application: Optional at both boards
Fingerprints: For out-of-state applicants, once the Department of Health asks: a fingerprint card and a $36 federal check
Jurisprudence exam: None
Interview: None
Board fee: MD $511; DO $391; both nonrefundable
Renewal: MD every two years, $996; DO every year, $461
CME: MD 200 hours every four years; DO 150 hours every three years

Which route fits.

MDs apply to the Washington Medical Commission and DOs to the Board of Osteopathic Medicine and Surgery, each under its own law and fee rule, directly or through the IMLC. Washington has no out-of-state telehealth registration: its telehealth law lets a physician licensed elsewhere consult with a Washington practitioner who stays responsible for the patient, give a specialty assessment or recommendation without treating, or provide continuity-of-care follow-up to an established patient who is temporarily in Washington. Other telehealth to patients located in Washington takes a Washington license, issued directly or through the compact.

The MD license.

Who it fits: MDs who will treat patients in Washington, in person or by telehealth, with 2 years of accredited postgraduate training and the USMLE or LMCC. Board certification is not required, and international graduates qualify with ECFMG certification and the same 2 years.
The trade-off: About $617 in fees from out of state, plus the local fingerprinting fee. The commission works from your USMLE scores, your FSMB and AMA profiles, and your work history, and asks for school, training, or other verifications only in some files; the FBI fingerprint check is what it calls the longest part of the process.

Licensing board: Washington Medical Commission.

The DO license.

Who it fits: DOs who will treat patients in Washington, in person or by telehealth, with 1 year of approved postgraduate training and COMLEX-USA, COMVEX, FLEX, or USMLE. State law bars the Medical Commission from licensing a DO, so every DO files with the osteopathic board.
The trade-off: About $492 in fees from out of state, plus the local fingerprinting fee, but a heavier file than an MD’s: your school, every state where you hold, held, or applied for a credential, and every hospital that granted you privileges in the past 5 years verify directly. The license also renews every year, at $461.

Licensing board: Washington State Board of Osteopathic Medicine and Surgery.

The IMLC.

Who it fits: Physicians whose state of principal license is another member state and who meet the compact’s terms: specialty certification, each USMLE or COMLEX-USA component passed within three attempts, ACGME or AOA training, and no discipline, convictions, controlled-substance actions, or open investigations. Washington can also be your state of principal license, through either board, if it is your primary residence or your state of residence for federal income tax purposes, your employer is located there, or at least 25% of your practice is there.
The trade-off: Compact fees of $1,211 for an MD or $1,111 for a DO, most of it the $700 IMLCC fee, against about $617 or $492 to apply directly. Your state of principal license runs the fingerprints and verifications, adding Washington to a Letter of Qualification still within its 365 days costs $611 or $511, and the Washington license renews through IMLCC with a $25 fee on top.

Temporary practice permits.

Who it fits: MDs with an active, unrestricted license in a state on the Medical Commission’s recognized list (15 states for US and Canadian graduates after July 28, 1985), who can practice for up to 90 days while the full application finishes, and MDs whose file is complete except the national background check result, who can practice under a 6-month permit, extendable once by 6 months. DOs licensed in a substantially equivalent state can request a single 180-day permit.
The trade-off: The 90-day MD permit costs $50 and the DO permit $70, both requested with the full application and nonrefundable. The commission warns that the last document a 90-day permit needs is often the last one the full license needs, and the osteopathic board says verifying another state’s standards can take longer than the full application.

The substantial equivalence waiver.

Who it fits: DOs credentialed for at least the 2 years before applying in a state the osteopathic board rates substantially equivalent, 30 of the 50 jurisdictions on its list, with no licensure gap over 90 days, no discipline in the 2 years before applying, and no pending investigation or charges. State law extends the same waiver to MDs, but the Medical Commission publishes no list or process for it.
The trade-off: It waives Washington’s education, training, experience, and exam requirements, but not the application fee, and the board still takes these files on its standard application. Its list, reviewed November 20, 2024, rates 20 jurisdictions not equivalent, among them Alaska, Georgia, Idaho, Illinois, Maryland, and Utah.

What it costs.

MD license, applying from out of state
Application fee, including the $16 HEAL-WA fee and the $70 physician health program surcharge	$511
USMLE transcript (FSMB)	$70
Federal fingerprint background check, paid to the Department of Health	$36
All-in	$617 plus the local fingerprinting fee
Our service fee	Quoted with your plan

DO license, applying from out of state
Application fee, including the $16 HEAL-WA fee	$391
COMLEX-USA transcript (NBOME)	$65
Federal fingerprint background check, paid to the Department of Health	$36
All-in	$492 plus the local fingerprinting fee
Our service fee	Quoted with your plan

The IMLC route, MD or DO
IMLCC fee	$700
Washington license fee, from the IMLCC fee table	$511 (MD) or $411 (DO)
All-in	$1,211 (MD) or $1,111 (DO)
Our service fee	Quoted with your plan

Both boards’ application fees go to the Department of Health and are nonrefundable under Washington’s fee rules. The $36 federal check is also paid to the department, and only after it notifies you that your prints are needed. Transcript fees go to FSMB or NBOME, and a DO who took the USMLE pays FSMB’s $70 transcript fee instead of NBOME’s $65, so about $497. On the IMLC route the $700 goes to IMLCC, which calls every compact fee nonrefundable; adding Washington to a Letter of Qualification still within its 365 days costs a $100 handling fee plus the state fee, $611 for an MD or $511 for a DO. IMLCC’s fee table lists $411 for a Washington DO license through the compact, $20 more than the $391 in Washington’s DO fee rule, which sets no separate compact fee.

Left out of every total: the local fee to have your prints taken, which no agency publishes; verifications from other states that have licensed you, which every DO file and some MD files need, at each state’s own fee; any fee a hospital charges to verify a DO’s privileges; FCVS, optional at both boards ($395), which includes your exam transcripts; ECFMG’s $70 certification status report for international graduates; and the optional temporary permits, $50 for an MD or $70 for a DO. On the IMLC route, your state of principal license runs the fingerprints and verifications at its own fees. A pending Department of Health rule would set the DO application at $386, including a new $70 surcharge at issuance, and the yearly DO renewal at $386.

Fees change; verified October 25, 2026.

How long it takes.

41.8 daysMedical Commission, average days to issue a licenseThe commission’s fiscal year 2025 performance report average, across all its license types (MD, IMLC, limited MD, and PA); the report does not say when the count starts.Board-published
Under 14 daysMedical Commission, complete file to licenseThe commission’s licensing page says review and approval take less than 14 days for 99% of its applicants once every document is in and background checks have cleared; the page carries no date.Board-published
Up to 12 weeksMedical Commission FAQ, processing timeThe commission’s FAQ calls up to 12 weeks the average processing time for a license application, without saying when it starts or stops; the answer carries no date.Board-published
43 daysHow far behind the Department of Health’s queue for DO applications runsOn October 22, 2026, the department listed September 9, 2026 as the oldest application date for the processing group that includes osteopathic physicians, 43 days earlier; it is a queue marker, not a processing time, and the department does not define it further.Board-published
30 daysLicense for a military spouse transferring to WashingtonWashington law requires each board’s expedited process to provide for a license, and a temporary license, within 30 days of a completed application, fees, fingerprints, and background check documents included, for a physician licensed in another state whose spouse is the subject of a military transfer to Washington. It applies to no other applicant.Statutory deadline
38 daysIMLC application to Letter of QualificationIMLCC’s Year 9 average across the compact, April 2025 to March 2026, over 10,837 completed applications; 55% received the letter in 30 days or less.IMLCC average
22 daysIMLC qualification to licenses issuedIMLCC’s Year 9 average for the next stage, from qualification to the requested state licenses; 47% received them in 7 days or less. The two stages are separate averages, not a total.IMLCC average

Outside the military spouse process, Washington sets no deadline for either board to act on a physician application. The Medical Commission treats some files as non-routine, outside its normal timeline: those with positive answers on state, hospital, or training verifications or on most personal data questions, and applicants without an active license who have not worked for more than three years. The osteopathic board asks that applications and documents be complete at least 60 days before you plan to start work in Washington, and the Department of Health says the out-of-state fingerprint check adds processing time. No board guarantees a date.

What the file involves.

An MD file moves between 5 parties besides you and 6 core document types, because the Medical Commission obtains your AMA profile itself and asks for school, training, hospital, or state verifications only in some files. A DO file moves between 8 parties, with 7 document types that you or third parties send and 4 reports the board obtains itself: the osteopathic board wants your school, every state where you hold, held, or applied for a credential, and every hospital that granted you privileges in the past 5 years to verify directly. On the IMLC route, the Washington file involves 3 parties: IMLCC, your state of principal license, and the Washington board.

FSMB or NBOMESends your USMLE or COMLEX-USA scores directly; MD applicants also make their FSMB profile available to the commission.
The AMA or AOAProvides your physician profile, which the department obtains itself; for DO files, an AOA report also verifies postgraduate training.
Your medical school (DO files)Sends your transcript directly to the department; MD files need one only if the commission asks.
Every state where you hold or held a credential (DO files)Verifies each credential, training licenses included, and any state where you applied without receiving one.
Every hospital that granted you privileges in the past 5 years (DO files)Verifies your admitting or specialty privileges directly to the department.
A fingerprinting providerTakes your prints on the department’s card, at a law enforcement office or a fingerprinting service, once the department asks.
The Washington State Patrol and the FBIRun the state and national criminal history checks for the department.
Your Washington boardThe Medical Commission or the osteopathic board reviews the file and issues the license; the osteopathic board also checks the FSMB and National Practitioner Data Bank records.

Postgraduate training, MD: 2 years in an ACGME program, or an RCPSC or CFPC program, with satisfactory evaluations; 1 year if you graduated before July 28, 1985. International graduates need the same 2 years, ECFMG certification, and English proficiency.
Postgraduate training, DO: 1 year: a nationally approved one-year internship, or the first year of a residency approved by the AOA or AMA.
Exams, MD: USMLE Steps 1 to 3 or the LMCC, or an accepted older exam or combination for earlier graduates. Under the commission’s rule, all USMLE steps must be passed within seven years of passing the first, with case-by-case exceptions for combined-degree programs; its requirements page does not mention the window, and its rules set no attempt limit.
Exams, DO: Any one of COMLEX-USA, COMVEX, FLEX, or USMLE, under the board’s rule as amended October 1, 2025, with no attempt or time limit in its rules.
Time out of practice: The commission may require SPEX of an MD who has not practiced in the 2 years before applying. A DO who has not actively practiced for at least 3 years must pass a competency evaluation or exam, or complete retraining or a reentry program; an active, unrestricted US DO license counts as active practice.

We run the Washington file.

We do

Confirm which board your degree goes to, and whether the IMLC, a direct application, or a temporary permit fits your licenses, before any fee is paid.
Prepare the application for the right board and check every answer against its current rules.
Request and chase every verification: your exam scores and FSMB profile, and for DO files your school, every state that has licensed you, and each hospital of the past 5 years.
Handle the fingerprint logistics as soon as the Department of Health asks, so the FBI check starts early.
Answer every board request and follow the file until the license issues.

You do

Share your credentials and license history once, in our secure portal.
Approve your application answers and sign the attestations.
Have your fingerprints taken in person when the Department of Health asks for them.
Complete Washington’s one-time trainings after licensure: 6 hours of suicide prevention and, if you prescribe opioids, 1 hour on opioid prescribing.

Get My Licensing Plan

Staying licensed.

Renewal cycle: MD licenses renew every two years on your birthday, for $996, and DO licenses every year on your birthday, for $461. A first license runs only to your first birthday after it issues, or to the one after that if it issues within 90 days of your birthday, so the first renewal can come within months. Late renewals add a $300 (MD) or $190 (DO) penalty, and the Medical Commission allows no grace period.
CME: MDs need 200 hours every four years, or an approved alternative such as ABMS certification, maintenance of certification participation, or the AMA Physician’s Recognition Award; residency and fellowship count 50 Category I hours a year. DOs need 150 hours every three years, at least 60 in Category 1, or an alternative such as ABOMS or ABMS certification within the last six years. Both boards require a one-time 6 hours of suicide prevention training and, to prescribe opioids, a one-time hour on opioid prescribing, each within your first full continuing education period after licensure, plus 2 hours of health equity training every four years, all counting toward the totals.
State controlled-substance registration: None. Washington exempts practitioners licensed under their professional licensing acts from its controlled-substance registration, so your license and DEA registration carry prescribing authority.
Prescription monitoring: MDs who prescribe Schedule II to V drugs in Washington register with the state’s prescription monitoring program, or show assured access to it, and make sure it is queried for opioids at set points: the first refill or renewal of an acute pain prescription, the moves to subacute and chronic pain, and periodically for chronic pain by risk level. DOs who prescribe opioids in Washington register, and make sure it is queried before every opioid or benzodiazepine prescription.
DEA registration: $888 for three years, with a separate registration for Washington.
E-prescribing: Required for Schedule II to V controlled substances since January 1, 2021, with exceptions such as a temporary technology failure, long-term care and hospice patients, prescriptions filled outside Washington, and department waivers; each violation can bring a $250 civil fine, up to $5,000 a calendar year.
Demographic census: MD renewals include the Medical Commission’s demographic census, and DO renewals the department’s demographic survey; the osteopathic board says skipping the survey may delay a renewal.
Licenses issued through the compact: They renew through IMLCC, with IMLCC’s $25 fee per renewal on top of Washington’s renewal fee, and IMLCC asks Washington MDs to complete the commission’s census too. The Medical Commission says it converts an MD license issued through the compact to a standard Washington license free of charge, which ends that $25 fee.
Self-reporting: State law requires license holders to report arrests, convictions, and other law enforcement findings for a criminal offense to their board, within 14 days of a conviction.