2026 How to Become an Occupational Therapist in Washington

by Imed Bouchrika, Phd

Co-Founder and Chief Data Scientist

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Washington state anticipates a 15% growth in occupational therapy jobs through 2030, reflecting increasing demand driven by an aging population and expanding healthcare services. Choosing a career as an occupational therapist in Washington offers competitive salaries and strong job security.

However, prospective students should also consider factors such as the rigorous education requirements and licensing processes before committing to this path. The local healthcare landscape and regional economic conditions can influence career outcomes, meaning that success depends on informed decision-making rather than assumptions about ready opportunities.

This article, prepared by experts in career planning, critically examines the steps to become an occupational therapist in Washington. It aims to provide clear, accurate guidance and help readers navigate educational prerequisites, licensure, and career prospects in this field.

Key Things to Know About Becoming an Occupational Therapist in Washington

What are the education requirements to become an occupational therapist in Washington?

Formal education forms the foundation for occupational therapists, equipping them with the skills necessary to address patients’ physical, emotional, and developmental needs. This preparation involves understanding complex concepts in physiology, psychology, and therapeutic techniques to promote independence in daily activities.

For those considering how to become an occupational therapist in Washington state, the educational pathway is structured and comprehensive.

Here are the typical education requirements to become a licensed occupational therapist in Washington:

• Bachelor's Degree: Aspiring occupational therapists usually begin with a bachelor’s degree, without a mandated major, though coursework in psychology, biology, and sociology is highly beneficial. These courses build a solid foundation for graduate studies, preparing students to engage deeply with occupational therapy principles.
• Master's or Doctoral Program in Occupational Therapy: The next step involves enrolling in an ACOTE-accredited master’s or doctoral program. These programs combine rigorous academic study with practical training and generally require about two years to complete, ensuring that students develop both theoretical knowledge and applied skills.
• Supervised Fieldwork Experience: Hands-on experience is essential, with a mandatory minimum of six months spent in supervised fieldwork. This practical phase allows students to apply their classroom learning in real-world settings, honing their ability to support diverse patient needs effectively.
• National Certification and Licensure: After graduation, candidates must pass the NBCOT exam and obtain state licensure from the Washington State Department of Health, confirming their qualifications and compliance with professional standards.

Similarly, it’s important to recognize that some may explore alternative related health careers; one useful resource detailing comparable pathways and credentialing is how to start your career in medical billing and coding, which offers insight into the broader medical support field.

How do you get a state license to practice occupational therapy in Washington?

Obtaining state licensure is a fundamental step for occupational therapists to establish professional credibility and comply with legal requirements in Washington. Without this license, individuals cannot practice legally, regardless of their educational achievements or national certifications. This process ensures that practitioners meet established standards for competency and patient care, making it a vital milestone in the Washington occupational therapy licensing process.

Below are the key steps typically involved in securing an occupational therapy license in Washington:

• Complete an Accredited Educational Program: Candidates must graduate from a program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE). This guarantees that the curriculum, including occupational therapy theory and clinical practice, meets nationally accepted standards.
• Fulfill Supervised Fieldwork Requirements: The state requires at least six months of supervised fieldwork experience under a licensed Occupational Therapist, providing essential practical training. For Occupational Therapy Assistants, the supervised experience is a minimum of two months.
• Pass the NBCOT National Certification Exam: Success on this standardized exam is mandatory, as it demonstrates the candidate’s clinical knowledge and skills. Passing allows use of the OTR credential and is a prerequisite for state licensure across all U.S. jurisdictions.
• Complete the Washington Jurisprudence Examination: Applicants must pass this online, open-book exam with a perfect score to show understanding of Washington’s specific laws and regulations governing occupational therapy practice.
• Submit Your State License Application: This step involves submitting a signed application with a $166 fee, providing official transcripts, and arranging for NBCOT and any other state licensing boards to send verifications directly to Washington.
• Complete Background Check Requirements: A criminal background check is mandatory to ensure the safety and integrity of occupational therapy professionals practicing in Washington.

Understanding the entire Washington occupational therapy license requirements, including this process, can provide clarity for prospective therapists. Navigating these steps carefully ensures compliance and helps avoid delays, a consideration also applicable to the work environment of medical billers and coders, who similarly face strict credentialing guidelines.

How often do you need to renew an OT license in Washington?

License renewal plays a vital role in maintaining professional standards and accountability for occupational therapists in Washington. By requiring practitioners to update their credentials periodically, the state ensures therapists remain informed of evolving clinical practices, regulations, and ethical expectations. This ongoing verification supports public safety and helps sustain a competent workforce aligned with current healthcare needs.

In Washington, occupational therapists must renew their licenses every two years on their birthday, marking a biennial cycle that coincides directly with each practitioner’s birth date. This approach standardizes renewal timing and encourages timely compliance. Missing the renewal deadline can lead to financial penalties, including late fees and potential reissuance costs, which serve as incentives to keep licensure active and valid.

The state’s system also includes continuing education mandates, reinforcing the profession’s focus on lifelong learning. By adhering to these requirements, occupational therapists maintain their eligibility to practice and stay responsive to new standards or regulations that affect their role within the healthcare system.

When asked about the process, an occupational therapist from Washington who graduated locally shared that, “Renewing my license every two years is a steady reminder to reflect on my professional growth and update my skills.” He noted that while the renewal deadlines felt strict initially, the structured schedule ultimately provided a clear framework to plan continuing education effectively. “It’s reassuring to know that I’m meeting state requirements and staying competent for my patients,” he added, emphasizing that the renewal process, though sometimes stressful, reinforces a deep commitment to quality care and professional responsibility.

What continuing education is required for OT license renewal in Washington?

Continuing education is essential for occupational therapists in Washington to maintain professional competence, comply with state standards, and stay current with evolving therapeutic techniques and regulatory requirements. These ongoing learning activities ensure practitioners incorporate the latest evidence-based practices, fostering better patient outcomes and trust within the healthcare community.

For anyone navigating the continuing education requirements for occupational therapists in Washington, understanding these obligations is key to sustaining one’s license and professional development.

• Total Required Hours: Washington mandates that occupational therapists and occupational therapy assistants complete 24 hours of continuing competency activities every two years. This biennial requirement ensures consistent knowledge updates across the profession and aligns with the license renewal timeline.
• Acceptable Course Topics and Formats: Continuing education must focus on occupational therapy practice areas such as clinical skills, ethical guidelines, laws, and emerging topics. While there is no explicit limit on online coursework hours, courses should be accredited by reputable organizations, such as those recognized by the Washington State Department of Health.
• Health Equity Education: Since December 2023, at least 2 hours must be dedicated to health equity, highlighting the state’s commitment to addressing disparities and promoting culturally sensitive care within diverse populations.
• Suicide Assessment Training: Every six years, licensees are required to complete 3 hours of suicide assessment, treatment, and management training. Although less frequent, this requirement underscores the critical role of mental health preparedness in occupational therapy.
• Reporting and Documentation: Licensees are responsible for maintaining verifiable records of completed continuing education for at least four years, as audits by the state may occur. Unlike some states, Washington does not require pre-approval of courses or centralized reporting, placing the onus on practitioners to keep thorough documentation.
• Additional OTA Requirements: Occupational therapy assistants must adhere to the same continuing education rules as occupational therapists, including biennial hours, health equity training, and suicide assessment coursework, reflecting the uniform standards expected across roles.

Those interested in expanding their skills might also explore options like a free online medical coding course to complement clinical knowledge and better navigate healthcare systems.

How much does it cost to become an occupational therapist in Washington?

The total cost of becoming an occupational therapist in Washington depends on various factors, including the type of educational program, certification exams, and state licensing fees. Being aware of these expenses enables prospective students to plan their finances more strategically and consider alternatives based on their individual circumstances.

• Tuition and Program Fees: Tuition varies widely between public and private institutions and program types. For example, a two-year master’s program at a public university may cost between $9,600 and $12,800 in tuition alone, while private programs can exceed $50,000 annually. Additional costs such as books, supplies, and fees should also be considered, as they add thousands to the total expense.
• NBCOT Certification Exam: Passing the National Board for Certification in Occupational Therapy exam is mandatory to practice, with a current fee of $550. This is a one-time cost but essential for licensure and employment eligibility.
• State Licensure Application Fees: Washington requires an initial licensure application fee of $166, with an option for a temporary license at an additional $55. Although these fees are modest compared to tuition, they are necessary part of the licensing process.
• Background Checks and Other Screening: Many programs and clinical sites require background checks, fingerprinting, and sometimes drug testing, totaling roughly $120 or more. These expenditures vary by provider but should not be overlooked when budgeting.
• Professional Memberships and Continuing Education: Optional but beneficial memberships, like those in AOTA or WOTA, incur annual dues and additional expenses for continuing education units required to maintain licensure. These ongoing costs, averaging about $11 per credit hour for CEUs, contribute to career sustainability.

What financial aid options are available for OT students in Washington?

Financial aid plays a vital role for occupational therapy students in Washington, helping to offset the high costs of graduate education and training. Pursuing a master’s degree or higher in occupational therapy requires significant financial resources, and without proper support, many prospective students may face barriers to entry.

Various aid types are accessible, each with distinct eligibility criteria and benefits to ease the financial burden. Below are the main financial aid options available for OT students in Washington.

• Federal Student Aid (FSA) — This includes unsubsidized Stafford Loans and Graduate PLUS Loans accessible by completing the FAFSA. These loans help cover tuition and living expenses but must be repaid with interest. Additionally, federal work-study programs offer part-time campus jobs that can supplement income during studies.
• University-Based Scholarships — Many Washington universities offering occupational therapy programs grant scholarships based on academic merit or financial need. These awards, sometimes administered directly through OT departments, can substantially reduce tuition costs and occasionally come as tuition remission.
• Washington Occupational Therapy Association Endowed Scholarship — Designed specifically for OT and OTA students in entry-level programs who are members of the state association. Candidates must have completed at least one year of coursework and supply academic and professional references, offering targeted support to motivated students.
• State and Professional Grants — While state-specific grants are limited, national organizations like the American Occupational Therapy Foundation offer scholarships that Washington residents may qualify for, helping diversify funding sources beyond federal and school aid.
• Private Scholarships and Awards — Numerous private foundations and organizations provide scholarships for OT students based on a range of criteria such as academic achievement or community involvement. These can be valuable supplements though researching and applying may require proactive effort from students.

Can out-of-state occupational therapists work in Washington?

Out-of-state occupational therapists can practice in Washington, but they must navigate a specific licensure process. Washington has joined the Occupational Therapy Licensure Compact to facilitate interstate practice; however, this system is not yet active. Until the Compact’s application process becomes operational, therapists licensed elsewhere must apply for a Washington state license through endorsement.

This requires verification that their qualifications, including education from an ACOTE-accredited program and NBCOT certification, meet Washington’s standards. The state does not have a formal reciprocity agreement, but endorsement functions similarly by recognizing comparable credentials.

Applicants should be prepared to submit detailed documentation, pay required fees, and potentially complete state-specific requirements like suicide assessment training. While the Compact promises future ease, for now, out-of-state OTs face a thorough vetting process to practice legally in Washington.

An occupational therapist from Washington shared that graduating locally provided her with clearer insight into the state’s expectations, but she empathizes with out-of-state peers who find the endorsement process "complex and time-consuming." She recalled hearing many express relief once licensure was secured but acknowledged the uncertainty surrounding the Compact’s full rollout often causes concern among newcomers navigating this transition.

What skills do you need to be a successful occupational therapist in Washington?

Occupational therapists in Washington require a diverse set of skills to effectively support clients in regaining independence, enhancing their quality of life, and integrating into their communities. These competencies are critical not only for individualized client care but also for navigating Washington’s stringent licensing and continuing education requirements.

Success in this profession hinges on a balanced mastery of clinical knowledge, interpersonal abilities, and ethical judgment, which together enable therapists to adapt to varied client needs and multidisciplinary healthcare settings. The following key skills illustrate the foundation for thriving as an occupational therapist in Washington.

• Clinical Expertise and Evidence-Based Practice: Deep understanding of anatomy and therapy techniques is essential, supported by at least six months of supervised fieldwork and ongoing education requirements, ensuring interventions remain current and effective.
• Communication and Interpersonal Skills: Clear, empathetic communication fosters trust and collaboration with clients and healthcare teams, facilitating tailored treatment plans and advocacy within multidisciplinary settings.
• Critical Thinking and Problem-Solving: Therapists must analyze complex cases creatively, adapting interventions to diverse urban, rural, and tribal populations with cultural sensitivity and practical solutions.
• Cultural Competence and Health Equity: Awareness of social determinants and mandated health equity training promote inclusive care, addressing disparities and improving client engagement statewide.
• Professionalism and Ethical Practice: Maintaining confidentiality, accountability, and compliance with regulatory standards protects clients and reinforces therapist credibility in Washington’s competitive healthcare environment.

What specializations are available for occupational therapists in Washington?

Specialization allows occupational therapists in Washington to concentrate their knowledge and skills on specific populations, conditions, or practice settings, which broadens their career prospects and deepens their professional impact. By honing expertise in particular areas, OTs can tailor interventions more effectively to diverse patient needs across the state’s healthcare landscape.

The following are some prominent occupational therapy specialties in Washington that reflect this focused approach.

• Pediatrics: Pediatric occupational therapist jobs in Washington often involve working with infants, children, and adolescents who experience developmental delays, disabilities, or injuries. These specialists operate in environments like public schools, early intervention programs, and pediatric hospitals, emphasizing skills such as play, self-care, and learning to support childhood participation in everyday activities.
• Geriatrics: Therapists in geriatric specialization support older adults managing challenges like reduced mobility, cognitive impairments, or chronic health issues. They typically work in nursing homes, assisted living facilities, or community health settings, focusing on maintaining independence and enhancing the quality of life for seniors.
• Mental Health: Occupational therapists working in mental health address emotional and psychological barriers that affect daily functioning. Their roles are often based in psychiatric units, community mental health centers, or outpatient clinics where they facilitate coping mechanisms, social engagement, and self-management through therapeutic activities.
• Hand Therapy: Specialists in hand therapy concentrate on rehabilitating the upper extremities after injury, surgery, or chronic conditions like arthritis. They are commonly found in orthopedic clinics, hospital rehab departments, and specialized outpatient centers.
• Physical Rehabilitation: Physical rehabilitation therapists assist patients recovering from strokes, surgeries, or chronic diseases by restoring movement and functionality. Their work settings include rehabilitation hospitals, outpatient clinics, and acute care facilities.

Some OTs also explore complementary fields such as medical billing and coding to enhance their administrative expertise; those interested might consider researching medical billing and coding online courses cost for additional professional options.

What is the average salary of an occupational therapist in Washington?

The average occupational therapist salary in Washington is influenced by several important factors, including experience, work setting, and location within the state. These elements shape how much occupational therapists can expect to earn in different circumstances. Below are key factors that affect occupational therapist pay in Washington:

• Years of Experience: Salary often rises with experience. Entry-level therapists may start near $75,460 annually, while those with extensive experience can earn up to $118,300. This reflects the increasing responsibility and expertise gained over time.
• Type of Employer: The employer type impacts compensation. Private practices tend to offer higher salaries, likely due to greater billing flexibility, whereas government or school positions might have steadier benefits but slightly lower pay.
• Geographic Location: Urban centers like Seattle usually pay more owing to higher living costs and demand. The average hourly wage statewide is about $51.39, but it varies significantly by area.
• Specialization and Certification: Therapists with specialized credentials in fields such as pediatrics or gerontology often command higher wages. While certifications like the Certified Occupational Therapist Assistant (COTA) primarily affect assistants, specialization remains a key salary factor.
• Market Demand: Areas with a growing need for occupational therapy, including regions with larger elderly populations, typically offer better compensation to attract qualified professionals.

What additional certifications enhance career growth for occupational therapists in Washington?

Occupational therapists in Washington can diversify and strengthen their professional profiles by acquiring advanced certifications that extend beyond traditional clinical practice. Specialized credentials in areas such as pediatric care, mental health, or neurological rehabilitation provide a competitive edge, enabling therapists to meet the multifaceted needs of diverse patient populations. Furthermore, cross-training in related fields—such as pursuing guidance on how to become a caregiver in Washington—can further broaden scope and service delivery. These targeted certifications not only improve job prospects and leadership potential but also signal a commitment to ongoing professional development and enhanced patient care outcomes.

What Do Occupational Therapists in Washington Say About Their Career?

References:

• Occupational Therapy | Knox College https://www.knox.edu/academics/majors-and-minors/occupational-therapy
• Occupational Therapists : Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics https://www.bls.gov/ooh/healthcare/occupational-therapists.htm
• School of Occupational Therapy https://www.pnwu.edu/academics/school-of-occupational-therapy/
• License Renewals | Washington State Department of Health https://doh.wa.gov/licenses-permits-and-certificates/professions-new-renew-or-update/license-renewals/renewals-online
• CE Requirements for Occupational Therapist in Washington - ChiroCredit https://www.chirocredit.com/stateApprovals/requirements/US-washington-Occupational_Therapist
• State of Washington Class Specification | Office of Financial Management https://ofm.wa.gov/state-human-resources/compensation-job-classes/ClassifiedJobListing/Specifications/29
• Learn the steps to occupational therapy state licensure. | AOTA https://www.aota.org/career/state-licensure/learn-the-steps-to-licensure
• Occupational Therapy - College of Health Science & Public Health - EWU - The Region's Polytechnic https://www.ewu.edu/chsph/occupational-therapy/
• Occupational Therapy Washington DC: Washington DC Occupational Therapy CE Requirements | Elite Learning https://www.elitelearning.com/occupational-therapy/washington-dc/requirements/
• Occupational Therapy Licensure Guide - Trusted Health https://www.trustedhealth.com/allied-career-guide/occupational-therapy/licensure-guide

Other Things You Should Know About Becoming an Occupational Therapist in Washington