Chapter 18.06 RCW


Formerly: Acupuncture


18.06.005Intent2010 c 286.
18.06.020Practice without license unlawful.
18.06.045Exemptions from chapter.
18.06.050Applications for examinationQualifications.
18.06.060Approval of educational programs.
18.06.070Approval of applicationsExamination fee.
18.06.080Authority of secretaryExaminationContentsImmunity.
18.06.090Fluency in English required.
18.06.100Investigation of applicant's background.
18.06.110Application of Uniform Disciplinary Act.
18.06.120Compliance with administrative proceduresFees.
18.06.130Patient information formPenalty.
18.06.140Consultation with other health care practitionersPatient waiverEmergenciesPenalty.
18.06.160Adoption of rules.
18.06.180Application of chapter to previously registered acupuncture assistants.
18.06.190Licensing by endorsement.
18.06.200Health care insurance benefits not mandatory.
18.06.210Prescription of drugs and practice of medicine not authorized.
18.06.220East Asian medicine advisory committee.
18.06.230Point injection therapy servicesEducation and training.


Performance of acupuncture by physician assistants and osteopathic physician assistants: RCW 18.57A.070.

Intent—2010 c 286.

The legislature intends to recognize that acupuncturists licensed by the state of Washington engage in a system of medicine to maintain and promote wellness and to prevent, diagnose, and treat disease drawing upon the experience, learning, and traditions originating in East Asia, which include more than acupuncture alone. To reflect this reality, the legislature intends to change the state's professional designation of acupuncturists to East Asian medicine practitioners and to incorporate current statutory provisions governing acupuncture, while recognizing treatments, methods, and techniques used in East Asian medicine. The legislature does not intend to require persons licensed under chapter 286, Laws of 2010 to change the business name of their practice if otherwise in compliance with chapter 286, Laws of 2010. It is further the intent that any federal law, regulation, or health insurance program applicable to licensed acupuncturists apply to persons licensed under chapter 286, Laws of 2010 as East Asian medicine practitioners.


The following terms in this chapter shall have the meanings set forth in this section unless the context clearly indicates otherwise:
(1) "East Asian medicine" means a health care service utilizing East Asian medicine diagnosis and treatment to promote health and treat organic or functional disorders and includes the following:
(a) Acupuncture, including the use of acupuncture needles or lancets to directly and indirectly stimulate acupuncture points and meridians;
(b) Use of electrical, mechanical, or magnetic devices to stimulate acupuncture points and meridians;
(c) Moxibustion;
(d) Acupressure;
(e) Cupping;
(f) Dermal friction technique;
(g) Infra-red;
(h) Sonopuncture;
(i) Laserpuncture;
(j) Point injection therapy (aquapuncture), as defined in rule by the department. Point injection therapy includes injection of substances, limited to saline, sterile water, herbs, minerals, vitamins in liquid form, and homeopathic and nutritional substances, consistent with the practice of East Asian medicine. Point injection therapy does not include injection of controlled substances contained in Schedules I through V of the uniform controlled substances act, chapter 69.50 RCW or steroids as defined in RCW 69.41.300;
(k) Dietary advice and health education based on East Asian medical theory, including the recommendation and sale of herbs, vitamins, minerals, and dietary and nutritional supplements;
(l) Breathing, relaxation, and East Asian exercise techniques;
(m) Qi gong;
(n) East Asian massage and Tui na, which is a method of East Asian bodywork, characterized by the kneading, pressing, rolling, shaking, and stretching of the body and does not include spinal manipulation; and
(o) Superficial heat and cold therapies.
(2) "East Asian medicine practitioner" means a person licensed under this chapter.
(3) "Department" means the department of health.
(4) "Secretary" means the secretary of health or the secretary's designee.
Nothing in this chapter requires individuals to be licensed as an East Asian medicine practitioner in order to provide the techniques and services in subsection (1)(k) through (o) of this section or to sell herbal products.

Practice without license unlawful.

(1) No one may hold themselves out to the public as an East Asian medicine practitioner, acupuncturist, or licensed acupuncturist or any derivative thereof which is intended to or is likely to lead the public to believe such a person is an East Asian medicine practitioner, acupuncturist, or licensed acupuncturist unless licensed as provided for in this chapter.
(2) A person may not practice East Asian medicine or acupuncture if the person is not licensed under this chapter.
(3) No one may use any configuration of letters after their name (including L. Ac. or EAMP) which indicates a degree or formal training in East Asian medicine, including acupuncture, unless licensed as provided for in this chapter.
(4) The secretary may by rule proscribe or regulate advertising and other forms of patient solicitation which are likely to mislead or deceive the public as to whether someone is licensed under this chapter.
(5) Any person licensed as an acupuncturist under this chapter prior to June 10, 2010, must, upon successful license renewal, be granted the title East Asian medicine practitioner or the letters EAMP indicating such license title. However, nothing in this section shall prohibit or limit in any way a practitioner licensed under this title from holding himself or herself out as an acupuncturist or licensed acupuncturist, or from using the letters L.Ac. after his or her name.

Exemptions from chapter.

Nothing in this chapter shall be construed to prohibit or restrict:
(1) The practice by an individual credentialed under the laws of this state and performing services within such individual's authorized scope of practice;
(2) The practice by an individual employed by the government of the United States while engaged in the performance of duties prescribed by the laws of the United States;
(3) The practice by a person who is a regular student in an educational program approved by the secretary, and whose performance of services is pursuant to a regular course of instruction or assignments from an instructor and under the general supervision of the instructor;
(4) The practice of East Asian medicine, including acupuncture, by any person credentialed to perform East Asian medicine, including acupuncture, in any other jurisdiction where such person is doing so in the course of regular instruction of a school of East Asian medicine, including acupuncture, approved by the secretary or in an educational seminar by a professional organization of East Asian medicine, including acupuncture, provided that in the latter case, the practice is supervised directly by a person licensed under this chapter or licensed under any other healing art whose scope of practice is East Asian medicine, including acupuncture.

Applications for examination—Qualifications.

Any person seeking to be examined shall present to the secretary at least forty-five days before the commencement of the examination:
(1) A written application on a form or forms provided by the secretary setting forth under affidavit such information as the secretary may require; and
(2) Proof that the candidate has:
(a) Successfully completed a course, approved by the secretary, of didactic training in basic sciences and East Asian medicine, including acupuncture, over a minimum period of two academic years. The training shall include such subjects as anatomy, physiology, microbiology, biochemistry, pathology, hygiene, and a survey of western clinical sciences. The basic science classes must be equivalent to those offered at the collegiate level. However, if the applicant is a licensed chiropractor under chapter 18.25 RCW or a naturopath licensed under chapter 18.36A RCW, the requirements of this subsection relating to basic sciences may be reduced by up to one year depending upon the extent of the candidate's qualifications as determined under rules adopted by the secretary;
(b) Successfully completed five hundred hours of clinical training in East Asian medicine, including acupuncture, that is approved by the secretary.


Findings2004 c 262: "The legislature finds that the health care workforce shortage is contributing to the health care crisis. The legislature also finds that some unnecessary barriers exist that slow or prevent qualified applicants from becoming credentialed health care providers. The legislature further finds that eliminating these initial barriers to licensure will contribute to state initiatives directed toward easing the health care personnel shortage in Washington." [ 2004 c 262 § 1.]

Approval of educational programs.

The department shall consider for approval any school, program, apprenticeship, or tutorial which meets the requirements outlined in this chapter and provides the training required under RCW 18.06.050. Clinical and didactic training may be approved as separate programs or as a joint program. The process for approval shall be established by the secretary by rule.

Approval of applications—Examination fee.

No applicant may be permitted to take an examination under this chapter until the secretary has approved his or her application and the applicant has paid an examination fee as prescribed under RCW 43.70.250. The examination fee shall accompany the application.

Authority of secretary—Examination—Contents—Immunity.

(1) The secretary is hereby authorized and empowered to execute the provisions of this chapter and shall offer examinations in East Asian medicine, including acupuncture, at least twice a year at such times and places as the secretary may select. The examination shall be a written examination and may include a practical examination.
(2) The secretary shall develop or approve a licensure examination in the subjects that the secretary determines are within the scope of and commensurate with the work performed by an East Asian medicine practitioner and shall include but not necessarily be limited to anatomy, physiology, microbiology, biochemistry, pathology, hygiene, and East Asian medicine, including acupuncture. All application papers shall be deposited with the secretary and there retained for at least one year, when they may be destroyed.
(3) If the examination is successfully passed, the secretary shall confer on such candidate the title of East Asian medicine practitioner.


Intent2009 c 560: "One of the key roles of advisory boards, committees, and commissions is to provide input, advice and recommendations from stakeholders, other interested parties, and the public to state agencies. Some advisory boards, committees, and commissions may be abolished without detriment to the mission of the agency each supports. Most of the advisory functions of some boards, committees, and commissions can be performed without the administrative costs of maintaining formal organizations. In the interest of building a leaner, more efficient, and more responsible government, this vital communications conduit must be maintained for the benefit of the state and its citizens, through the use of modern communication technology. It is the intent of the legislature this interim to identify criteria to evaluate those advisory boards, committees, and commissions that may be eliminated or consolidated, and for agencies to identify new, less costly, and more effective opportunities to ensure a broad range of citizen participation is provided and that all reasonable efforts are made to ensure that channels are maintained for vital input from the citizens of Washington." [ 2009 c 560 § 1.]
Effective date2009 c 560: "This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect June 30, 2009." [ 2009 c 560 § 30.]
Disposition of property and fundsAssignment/delegation of contractual rights or duties2009 c 560: "(1) All documents and papers, equipment, or other tangible property in the possession of the terminated entity shall be delivered to the custody of the entity assuming the responsibilities of the terminated entity or if such responsibilities have been eliminated, documents and papers shall be delivered to the state archivist and equipment or other tangible property to the *department of general administration.
(2) All funds held by, or other moneys due to, the terminated entity shall revert to the fund from which they were appropriated, or if that fund is abolished to the general fund.
(3) All contractual rights and duties of an entity shall be assigned or delegated to the entity assuming the responsibilities of the terminated entity, or if there is none to such entity as the governor shall direct." [ 2009 c 560 § 28.]
*Reviser's note: The department of general administration was renamed the department of enterprise services by 2011 1st sp.s. c 43 § 107.
SeverabilityHeadings and captions not lawEffective date1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.

Fluency in English required.

Before licensure, each applicant shall demonstrate sufficient fluency in reading, speaking, and understanding the English language to enable the applicant to communicate with other health care providers and patients concerning health care problems and treatment.

Investigation of applicant's background.

Each applicant shall, as part of his or her application, furnish written consent to an investigation of his or her personal background, professional training, and experience by the department or any person acting on its behalf.

Application of Uniform Disciplinary Act.

The Uniform Disciplinary Act, chapter 18.130 RCW, governs uncertified practice, the issuance and denial of licenses, and the disciplining of license holders under this chapter. The secretary shall be the disciplining authority under this chapter.


Severability1987 c 150: See RCW 18.122.901.

Compliance with administrative procedures—Fees.

(1) Every person licensed under this chapter shall comply with the administrative procedures and administrative requirements for registration and renewal set by the secretary under RCW 43.70.250 and 43.70.280.
(2) All fees collected under this section and RCW 18.06.070 shall be credited to the health professions account as required under RCW 43.70.320.

Patient information form—Penalty.

(1) The secretary shall develop a form to be used by a person licensed under this chapter to inform the patient of the scope of practice and qualifications of an East Asian medicine practitioner. All license holders shall bring the form to the attention of the patients in whatever manner the secretary, by rule, provides.
(2) A person violating this section is guilty of a misdemeanor.


IntentEffective date2003 c 53: See notes following RCW 2.48.180.

Consultation with other health care practitioners—Patient waiver—Emergencies—Penalty.

(1) When a person licensed under this chapter sees patients with potentially serious disorders such as cardiac conditions, acute abdominal symptoms, and such other conditions, the practitioner shall immediately request a consultation or recent written diagnosis from a primary health care provider licensed under chapter 18.71, 18.57, 18.57A, 18.36A, or 18.71A RCW or RCW 18.79.050. In the event that the patient with the disorder refuses to authorize such consultation or provide a recent diagnosis from such primary health care provider, East Asian medical treatments, including acupuncture, may only be continued after the patient signs a written waiver acknowledging the risks associated with the failure to pursue treatment from a primary health care provider. The waiver must also include: (a) An explanation of an East Asian medicine practitioner's scope of practice, including the services and techniques East Asian medicine practitioners are authorized to provide and (b) a statement that the services and techniques that an East Asian medicine practitioner is authorized to provide will not resolve the patient's underlying potentially serious disorder. The requirements of the waiver shall be established by the secretary in rule.
(2) In an emergency, a person licensed under this chapter shall: (a) Initiate the emergency medical system by calling 911; (b) request an ambulance; and (c) provide patient support until emergency response arrives.
(3) A person violating this section is guilty of a misdemeanor.


IntentEffective date2003 c 53: See notes following RCW 2.48.180.

Adoption of rules.

The secretary shall adopt rules in the manner provided by chapter 34.05 RCW as are necessary to carry out the purposes of this chapter.

Application of chapter to previously registered acupuncture assistants.

All persons registered as acupuncture assistants pursuant to chapter 18.71A or 18.57A RCW on July 28, 1985, shall be certified under this chapter by the secretary without examination if they otherwise would qualify for certification under this chapter and apply for certification within one hundred twenty days of July 28, 1985.

Licensing by endorsement.

The secretary may license a person without examination if such person is credentialed as an East Asian medicine practitioner or licensed acupuncturist, or equivalent, in another jurisdiction if, in the secretary's judgment, the requirements of that jurisdiction are equivalent to or greater than those of Washington state.

Health care insurance benefits not mandatory.

Nothing in this chapter may be construed to require that individual or group policies or contracts of an insurance carrier, health care service contractor, or health maintenance organization provide benefits or coverage for services and supplies provided by a person licensed under this chapter.

Prescription of drugs and practice of medicine not authorized.

This chapter shall not be construed as permitting the administration or prescription of drugs or in any way infringing upon the practice of medicine and surgery as defined in chapter 18.71 or 18.57 RCW, except as authorized in this chapter.

East Asian medicine advisory committee.

The Washington state East Asian medicine advisory committee is established. 
(1) The committee consists of five members, each of whom must be a resident of the state of Washington. Four committee members must be East Asian medicine practitioners licensed under this chapter who have not less than five years' experience in the practice of East Asian medicine and who have been actively engaged in practice within two years of appointment. The fifth committee member must be appointed from the public at large and must have an interest in the rights of consumers of health services.  
(2) The secretary shall appoint the committee members. Committee members serve at the pleasure of the secretary. The secretary may appoint members of the initial committee to staggered terms of one to three years, and thereafter all terms are for three years. No member may serve more than two consecutive full terms.
(3) The committee shall meet as necessary, but no less often than once per year. The committee shall elect a chair and a vice chair. A majority of the members currently serving constitutes a quorum.
(4) The committee shall advise and make recommendations to the secretary on standards for the practice of East Asian medicine.
(5) Committee members must be compensated in accordance with RCW 43.03.240, including travel expenses in carrying out his or her authorized duties in accordance with RCW 43.03.050 and 43.03.060.
(6) Committee members are immune from suit in an action, civil or criminal, based on the department's disciplinary proceedings or other official acts performed in good faith.

Point injection therapy services—Education and training.

(1) Prior to providing point injection therapy services, an East Asian medicine practitioner must obtain the education and training necessary to provide the service. The department shall adopt rules by July 1, 2017, to specify the education and training necessary to provide point injection therapy.
(2) Any East Asian medicine practitioner performing point injection therapy prior to June 9, 2016, must be able to demonstrate, upon request of the department of health, successful completion of education and training in point injection therapy.