State guide · Washington
Starting a Medical Practice in Washington
What physicians need to know about Washington's regulatory environment, entity requirements, and practice-specific rules.
Entity required
Professional Service Corporation or Professional LLC
LLC permitted
No
CPOM enforcement
Moderate
Top income tax
None (B&O tax instead; 7% capital gains tax above threshold)
Min. franchise tax
None (B&O tax applies on gross receipts)
Med board registration
Not required
The information on this page is provided for general reference only and may not reflect recent regulatory or legislative changes. Entity formation requirements, tax rates, and CPOM rules vary by state and change frequently. Always verify requirements with your state's official agencies, a qualified healthcare attorney, or a CPA with medical practice experience before making business formation decisions. Nothing on this page constitutes legal or financial advice.
Entity Requirements
Washington physicians may form a Professional Service Corporation under RCW Chapter 18.100 or a Professional Limited Liability Company under RCW Chapter 25.15. All shareholders or members must be licensed Washington physicians.
Filing is with the Washington Secretary of State, Corporations Division.
- •Form a Professional Service Corporation or Professional LLC
- •All shareholders/members must be licensed Washington physicians
- •File Articles of Incorporation or Certificate of Formation with the WA Secretary of State
- •Entity name must reflect professional status
- •File an Initial Report within 120 days and Annual Report each year
- •Obtain a Washington Business License through the Department of Revenue
Corporate Practice of Medicine
Washington recognizes a moderate Corporate Practice of Medicine doctrine. The Washington Medical Commission disfavors lay ownership of medical practices, and fee-splitting is prohibited under WAC 246-919-606.
MSO arrangements are common. The MSO must avoid clinical control and fee-splitting structures.
Tax Considerations
Washington has no personal or corporate income tax. Instead, the state imposes a Business & Occupation (B&O) tax on gross receipts. For services (including medical services), the B&O rate is approximately 1.75% — verify current rate. Washington also imposes a 7% capital gains tax on gains over a threshold (currently around $270,000).
Washington has no franchise tax. Local B&O taxes are imposed by Seattle and other cities.
- •No personal or corporate income tax
- •Business & Occupation (B&O) tax on gross receipts: Verify — approximately 1.75% for services
- •7% capital gains tax on gains above ~$270K threshold (Verify current threshold)
- •Seattle and some cities impose local B&O taxes
- •Washington Paid Family & Medical Leave premium (employer/employee split)
Washington Medical Commission
Washington does not require entity registration with the Medical Commission. Individual physicians are licensed; the entity registers with the Secretary of State and obtains a Business License through the Department of Revenue.
- •No general entity registration with the Medical Commission required
- •All practicing physicians must hold an active WA medical license
- •Office-based surgery and certain practice types may require additional Department of Health credentials
Employment Law Considerations
Washington has expansive employee protections. Mandatory paid sick leave (1 hour per 40 hours worked), paid family and medical leave, and a high state minimum wage ($16.28/hour in 2024) all add compliance requirements. Non-compete enforceability is limited by RCW 49.62, which restricts non-competes for employees earning under specified thresholds.
Seattle adds the Paid Sick and Safe Time Ordinance, Secure Scheduling Ordinance, and a higher local minimum wage.
- •Paid Sick Leave: 1 hour earned per 40 hours worked
- •Washington Paid Family & Medical Leave (employee + employer premium)
- •Washington Cares Fund (long-term care) payroll tax of 0.58%
- •High state minimum wage ($16.28 in 2024 — adjusts annually)
- •Non-compete restrictions: RCW 49.62 limits non-competes; physician non-competes scrutinized closely
- •Pay transparency required on job postings
Official resources
Bookmark these official agency portals for Washington entity formation, tax registration, and medical board information.
Looking for Washington licensing and credentialing information?
State medical license requirements, controlled-substance registration, and Medicaid enrollment specifics for Washington.
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