Washington licenses occupational therapists and occupational therapy assistants through the Department of Health, with the Occupational Therapy Practice Board. You need a passing NBCOT score; a limited permit lets you work under a sponsor before that. Everything below comes from the board's own pages and rules, checked October 18, 2026. Fees and rules change, so confirm on the linked pages before you pay.
Check with your board. OT Ticket is a study aid, not clinical or legal guidance. Not affiliated with, endorsed by or connected to the National Board for Certification in Occupational Therapy (NBCOT), AOTA, ACOTE, the OT Compact Commission or any state board; NBCOT, OTR and COTA are their marks, used here only to name the exam.
Washington at a glance
Occupational therapist (OT)
OT assistant (OTA)
Exam
NBCOT OTR exam (180 questions, 4 hours), $540 to NBCOT
NBCOT COTA exam (190 questions, 4 hours), $540 to NBCOT
Board fees
$166 application and initial license (includes $16 HEALWA surcharge)
$166
Limited permit
$55, with a Limited Permit Sponsor Information Form
$45
Background check
Not spelled out on the DOH licensing pages; check with DOH
Same
OT Compact
Member, not accepting applications yet. Washington has enacted the OT Compact but has not opened privilege applications, so for now you need a full Washington license. (OT Compact, checked October 18, 2026)
Washington, step by step
Washington Occupational Therapy Practice Board (Department of Health)
Apply online with the Department of Health: $166 for the application and initial license, OT or OTA (WAC 246-847-990). It includes a $16 surcharge for the University of Washington's HEALWA online library. Fees are non-refundable.
NBCOT: you must obtain a passing score on the NBCOT exam.
Limited permit (optional): DOH issues limited permits ($55 OT, $45 OTA) with a Limited Permit Sponsor Information Form; ask DOH for the eligibility rules before you apply.
Keep it: licenses renew every two years ($157 OT, $137 OTA, each including a $32 HEALWA surcharge) with 24 hours of continued competency. Washington has enacted the OT Compact but is not accepting privilege applications yet.
Every state licenses occupational therapists and OT assistants on NBCOT certification: an ACOTE-accredited degree with its Level II fieldwork, then NBCOT's exam (the OTR exam for OTs, 180 questions in 4 hours; the COTA exam for OT assistants, 190 questions in 4 hours; 450 on a 300-600 scale passes; $540 to apply online). NBCOT certification is not a license: you apply to your state board separately, and NBCOT sends the board your score (the Score Transfer is free if you add it when you apply for the exam, $35 later). The full walk-through: How to get your OT license.