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EMT / Paramedic
Governing Authority
Washington State Department of Health, Office of Community Health Systems, EMS & Trauma Section
Official website →Some details on this page are not yet confirmed against an official source. See sources below or contact the licensing board to verify.
Yes
NREMT Required?
120-150
EMT Training Hours
4 levels
Certification Levels
Course + $104 (NREMT) + $0 (state fees) + possible background check
EMT Initial Cost
3 years (coinciding with supervisory EMS agency license expiration month)
Renewal Period
40 hrs
EMT CE Hours
Training Hours
60 hours
Scope of Practice
Basic emergency care including bleeding control, CPR, AED use, oxygen administration, and basic patient assessment
NREMT Required
Yes
Additional Requirements
Training Hours
120-150 hours
Scope of Practice
BLS care including patient assessment, vital signs, oxygen therapy, BVM ventilation, CPR/AED, splinting, bleeding control, assisted medication administration (epinephrine auto-injector, nitroglycerin, albuterol), emergency childbirth, and spinal motion restriction
NREMT Required
Yes
Additional Requirements
Training Hours
350 hours
Scope of Practice
All EMT-Basic skills plus IV/IO access, fluid administration, supraglottic airway devices, blood glucose monitoring, CPAP, and limited medication administration per protocol
NREMT Required
Yes
Additional Requirements
Training Hours
1,200 hours
Scope of Practice
All AEMT skills plus endotracheal intubation, cardiac monitoring/12-lead ECG, manual defibrillation and cardioversion, transcutaneous pacing, needle chest decompression, surgical cricothyrotomy, comprehensive medication administration, and rapid sequence intubation where authorized
NREMT Required
Yes
Additional Requirements
Training Program Requirements
Verified120-150
EMT Training Hours
1,200
Paramedic Hours
Notes
Washington EMT training programs must meet NHTSA National EMS Education Standards. Agency affiliation and Medical Program Director approval are required. Washington does NOT follow the NREMT NCCP model for recertification and uses its own CME or OTEP pathways instead.
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Exam Requirements
VerifiedRequired
NREMT Certification
Required
Cognitive Exam
Required
Psychomotor Exam
No
State-Specific Exam
NREMT Details
Washington requires NREMT for initial certification but does NOT require NREMT for recertification. Washington uses its own renewal pathways (CME or OTEP) and does NOT follow the NREMT NCCP model. The NREMT cognitive exam is a Computer Adaptive Test (CAT) with 70-120 questions for EMT level, a 2-hour time limit, and costs $104 per attempt. A scaled passing score of 950/1500 is required. Candidates are allowed up to 3 attempts within 12 months. Psychomotor exam is administered by the state.
State Exam Details
No state-specific exam. NREMT cognitive and/or psychomotor exam required for certification.
Passing Score
NREMT uses Computer Adaptive Testing (CAT). EMT exam has 70-120 questions with a 2-hour time limit. A scaled passing score of 950/1500 is required. Cost is $80 per attempt.
Retake Policy
Washington allows up to 3 exam attempts within 12 months. NREMT standard policy: 6 attempts with a 15-day waiting period between attempts. After the 3rd failed attempt, 24 hours of remedial training required.
Didn't pass on the first try? Learn what to do if you fail the NREMT.
Overall licensing difficulty: 1/100
Study recommendation: 1–2 weeks of focused review is usually sufficient
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NREMT (EMT Certification Exam)
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NREMT Cognitive Exam
Questions
120 questions
Time Limit
2 hours
Passing Score
NREMT uses Computer Adaptive Testing (CAT). EMT exam has 70-120 questions with a 2-hour time limit. A scaled passing score of 950/1500 is required. Cost is $80 per attempt.
Format
Computer adaptive testing (CAT)
Cost of failing
Retake fee: $80Invest in preparation to pass the first time.
How long should you study? Most candidates study 2–4 weeks before taking the NREMT Cognitive Exam.
Study Materials & Exam Prep — NREMT Certification Exam
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Study guides and practice tests for the NREMT certification exam.
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What Each Level Can Do
VerifiedOnline Medical Direction (Real-Time)
Real-time physician contact via radio or phone for consultation on patient care decisions beyond standing orders
Offline Medical Direction (Standing Orders)
Standing orders and protocols developed by the EMS medical director that authorize specific treatments without real-time physician contact
Protocol Requirements
All EMS providers in Washington must operate under the authority of a Medical Program Director. Each county/region has a Medical Program Director who approves credentials and protocols.
Minimum Age
Education
Background Check
Drug Screening
CPR/BLS Certification
Immunizations Required
Driver's License Required
Not sure if you need a emt license? Check whether your state requires one.
| Fee | Amount |
|---|---|
NREMT Exam Fee NREMT EMT cognitive exam fee (increased from $70 in 2025) | $80 |
State Application Fee Washington charges NO certification fees | $0 |
State License Fee Washington charges NO certification fees | $0 |
Renewal Fee Washington charges NO certification fees for renewal | $0 |
Total Initial EMT Cost Washington charges NO state certification fees; only NREMT and course costs apply | Course + $104 (NREMT) + $0 (state fees) + possible background check |
Total Initial Paramedic Cost Washington charges NO state certification fees; only NREMT and course costs apply | Course + $104 (NREMT) + $0 (state fees) + possible background check |
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Renewal & CE Requirements
Verified3 years (coinciding with supervisory EMS agency license expiration month)
Renewal Period
40 hrs
EMT CE Hours
60 hrs
Paramedic CE Hours
Required
Skills Verification
NREMT Recertification Accepted for State Renewal
CE Topics
Renewal Fee
$0
Washington charges NO certification fees for renewal
Regulatory Board
EMS certifications must be renewed on schedule. Most states require continuing education covering patient assessment, trauma care, cardiac emergencies, and applicable protocol updates.
For a deeper dive into CE requirements and deadlines, see our emt license renewal guide.
Out-of-State Reciprocity
VerifiedAccepts Out-of-State Credentials
NREMT-Based Reciprocity Available
Reciprocity Type
NREMT-based; NOT an EMS Compact member state
Transfer Details
Washington accepts reciprocity applications with current NREMT certification. Washington is NOT an EMS Compact member state. Agency affiliation and Medical Program Director approval are required.
Additional Requirements for Transfer
EMT/Paramedic reciprocity is often facilitated through NREMT certification. States that require NREMT typically allow easier transfer for certified providers. Always verify current reciprocity policies with your state EMS office.
See all EMS Compact (REPLICA) member states & eligibility details →
Moving to another state? Use our Transfer Tool to see what you need →
Compare Washington with other states →
See how requirements, costs, and timelines differ across all 50 states.
Washington charges NO certification fees at all, making it one of the most affordable states. The state has a 3-year certification cycle with only 15 CE hours required per cycle, one of the lowest in the nation. Washington does NOT follow the NREMT NCCP model for recertification, using its own CME or OTEP pathways instead. Agency affiliation and Medical Program Director approval are required. Candidates get up to 3 exam attempts within 12 months, which is more restrictive than the standard NREMT 6-attempt policy.
Washington charges NO certification fees at all, making it one of the most affordable states for EMS certification.
Washington has a 3-year certification cycle.
Only 15 CE hours required per 3-year cycle for EMTs, one of the lowest requirements in the nation.
Washington does NOT follow the NREMT NCCP model for recertification; uses its own CME or OTEP pathways.
Agency affiliation and Medical Program Director approval are required for certification.
Up to 3 exam attempts within 12 months (more restrictive than NREMT standard 6 attempts).
Background check may include fingerprint-based WA State Patrol + FBI check.
Washington is NOT an EMS Compact member state.
EMT requirements in nearby states
Other professional licenses in Washington
See how Washington compares: EMT License Fees by State — Cheapest to Most Expensive →
Washington is not currently a member of the EMS Compact (REPLICA). EMT licensees must apply through standard reciprocity or endorsement. See which states are in the REPLICA →
Related Guides
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Official Sources
EMT requirements in Washington verified against Washington State Department of Health, Office of Community Health Systems, EMS & Trauma Section, March 2026.
Moving to Washington? Use our free Transfer Tool to see what you need →
Already licensed elsewhere? See how to transfer your EMT license to Washington →
Washington requires NREMT certification for EMS providers. EMT training requires 120-150 hours. All certification is managed through the Washington State Department of Health, Office of Community Health Systems, EMS & Trauma Section.
Requirements vary by state and local jurisdiction. Always verify current requirements with your state EMS office.
EMT Schools in Washington
Compare approved training programs, costs, and requirements.