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EMS reciprocity requirements for King County and Washington state

In King County there are two recognized levels of pre-hospital care: Paramedic and EMT-B. In all counties in Washington state except for King, you may be able to reciprocate your current recognized level of care. In King County, you can only reciprocate as an EMT-B.

The following steps are required to gain reciprocity as an EMT-B from other states or the National Registry.

  • HIV/AIDS prevention education

    Complete a Health Department approved HIV/AIDS Prevention class (Note: you must complete the 7-hour course approved for Washington state). Visit the WA State Dept. of Health's HIV/AIDS Training for Licensure webpage for a list of approved organizations that have web-based applications that can help you meet this requirement.

  • National Registry Basic Card

    If you do not already possess a National Registry Basic Card, you will need to obtain one. If you have a National Registry Card and have not re-tested within a year from the time it was issued (written exam) then you will need to take the National Registry Assessment Exam for Washington State. This exam is administered through the National Registry. Information on how to do this can be found at the National Registry of Emergency Medical Technicians website.

  • Out-of-state reciprocity

    Complete pages 1-4 of Out-of-State reciprocity application (PDF). Be sure to read the instructions, print it out and complete it in ink. If you have any questions on about application, please call the Washington State Department of Health (WA DOH) at 360-236-4700 to speak with someone for clarification.

  • EMS verification form

    Complete the EMS Verification Form (part 4 of the application). After completing the EMS Verification Form send it directly to the state EMS office in which you obtained your credential. If you do not, it will delay your Washington State credential from being issued.

    You can usually find the address for your state office by using the internet. Use your favorite internet search to search for YOUR State then EMS. The purpose of this form allows the state from where you hold your current certification to disclose your EMS records to Washington State. If you are only National Registry Certified, you do not need to complete this part of the application.

  • EMS Supervisor / Medical Program Director Signature Form

    This is the last part of the application process and form in your Application packet. You are eligible for certification as an EMT-B in Washington State when you find agency affiliation. Your next step is to gain agency affiliation with a pre-hospital care agency such as ambulance or fire service in Washington state.

    For those seeking an ER or surgery Tech position, these are not considered to be pre-hospital care agencies and will not work in order to obtain a Washington State credential. Depending on the institution your National Registry certification may suffice instead, you will need to check with the institution that you wish to seek employment with for clarification.

    When you establish agency affiliation, you will need to complete the EMS Supervisor / Medical Program Director Signature Form with the prospective agency in which you wish to work or volunteer. Your agency supervisor will then send it to our office for MPD signature. We will then send it the Washington State Department of Health (DOH) who will then issue your credential. An EMT-B card will be mailed to you at the address on the application within 6 weeks' time. If there is a problem with your application, WA DOH will contact you directly for clarification by letter.