Dry needling in Washington: the rules for physical therapists

Since 2023 Washington law (RCW 18.74.200) lets PTs perform intramuscular needling (dry needling) once they hold an intramuscular needling endorsement from the Department of Health (WAC 246-915-390, effective June 22, 2024).

Allowedfor PTs

325 hours: 100 didactic, 75 in-person needling instruction, and a clinical review of 150 treatment sessions, plus 1 year of full-time practice. Then apply for an endorsementtraining before you start

Rules to know

The 100 didactic hours cover musculoskeletal and neuromuscular anatomy and physiology, pain mechanisms, trigger points, universal precautions and emergency response. CAPTE pre-licensure coursework can count.
After the instruction, you have up to 18 months to complete the 150 reviewed treatment sessions with a qualified provider.
Dry needling can't be delegated, and you must stay with the patient for the whole procedure.
Patients sign an informed consent form. The endorsement fee is $100.

Official sources

A plain-language summary, last checked October 24, 2026. Dry needling rules change often and some states regulate it through board statements rather than law, so confirm with your board before you dry needle. OTs and athletic trainers have their own rules.

Dry needling courses in Washington

29 upcoming in-person courses. Make sure a course's hours and format meet Washington's rules before you register.

October 2026

Fri–Sun, Oct 23–25, 2026 · 3 days Functional Dry Needling Level 1 (3-Day) Price on provider site · Spokane Evidence in Motion· Eastern Washington UniversityDry Needling Details and registration

November 2026

Fri–Sun, Nov 13–15, 2026 · 3 days Dry Needling 2 (DN-2) $895 · Seattle AAMT· Seattle, WADry Needling Details and registration
Fri–Sun, Nov 13–15, 2026 · 3 days IDN Complex Persistent Pain Course $1,295 · Seattle Integrative Dry Needling· Renew Physical TherapyDry Needling Details and registration

December 2026

Fri–Sun, Dec 11–13, 2026 · 3 days Dry Needling 1 (DN-1) $895 · Tacoma AAMT· Tacoma, WADry Needling Details and registration
Fri–Sun, Dec 11–13, 2026 · 3 days Functional Dry Needling: Clinical Integration (3-Day) Price on provider site · 27.75–33 contact hrs · Spokane Evidence in Motion· Eastern Washington UniversityDry Needling Details and registration
Fri–Sun, Dec 11–13, 2026 · 3 days Dry Needling and Pelvic Health Level 2 $995 · Seattle Herman & Wallace· Flow RehabDry Needling Details and registration
Fri–Sun, Dec 11–13, 2026 · 3 days Dry Needling: Upper Body $1,295 · Seattle ICE Physio· Go PT – Nickerson St.Dry Needling Details and registration
Fri–Sun, Dec 18–20, 2026 · 3 days Dry Needling 2 (DN-2) $895 · Tacoma AAMT· Tacoma, WADry Needling Details and registration

January 2027

Fri–Sun, Jan 15–17, 2027 · 3 days Dry Needling: Lower Body $1,295 · Bellevue ICE Physio· Onward BellevueDry Needling Details and registration
Fri–Sun, Jan 22–24, 2027 · 3 days Dry Needling 1: Foundations I $1,250 · 38 contact hrs · Seattle Myopain Seminars· Seattle Institute of East Asian Medicine - Seattle WADry Needling Details and registration
Fri–Sun, Jan 22–24, 2027 · 3 days Trigger Point Acupuncture / Dry Needling 1 $1,250 · 27.5 contact hrs · Seattle Myopain Seminars· Seattle Institute of East Asian Medicine - Seattle WADry Needling Details and registration

February 2027

Fri–Sun, Feb 19–21, 2027 · 3 days Dry Needling: Upper Body $1,295 · Bellevue ICE Physio· Onward BellevueDry Needling Details and registration

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Common questions

Can physical therapists dry needle in Washington?

Yes. Since 2023 Washington law (RCW 18.74.200) lets PTs perform intramuscular needling (dry needling) once they hold an intramuscular needling endorsement from the Department of Health (WAC 246-915-390, effective June 22, 2024).

How much training do PTs need to dry needle in Washington?

325 hours: 100 didactic, 75 in-person needling instruction, and a clinical review of 150 treatment sessions, plus 1 year of full-time practice. Then apply for an endorsement.