Washington Certified Nurse-Midwife license renewal and CE requirements
Washington nurse-midwives must complete 30 contact hours of continuing education every two years to renew their license with the Washington State Board of Nursing (Nursing Care Quality Assurance Commission).
The advanced registered nurse practitioner license, which is the license a Washington nurse-midwife holds under the certified nurse-midwife designation, renews every other year on the licensee's birthday. The underlying registered nurse license renews every year on the same birthday, so a nurse-midwife files a registered nurse renewal in the off years and both renewals in the on years. Renewal is completed in the HELMS portal with an attestation that the renewal requirements were met. Prescriptive authority, for a nurse-midwife who holds it, is renewed at the same time as the ARNP license, and a nurse-midwife who lets prescriptive authority expire may not prescribe until it is renewed.
Summary
Washington nurse-midwives must complete 30 contact hours of continuing education every two years to renew their license with the Washington State Board of Nursing (Nursing Care Quality Assurance Commission). The advanced registered nurse practitioner license, which is the license a Washington nurse-midwife holds under the certified nurse-midwife designation, renews every other year on the licensee's birthday. The underlying registered nurse license renews every year on the same birthday, so a nurse-midwife files a registered nurse renewal in the off years and both renewals in the on years. Renewal is completed in the HELMS portal with an attestation that the renewal requirements were met. Prescriptive authority, for a nurse-midwife who holds it, is renewed at the same time as the ARNP license, and a nurse-midwife who lets prescriptive authority expire may not prescribe until it is renewed. Washington also mandates specific subjects. Pharmacotherapeutics continuing education for ARNP prescriptive authority: 15 contact hours every renewal cycle (certified nurse-midwives who hold ARNP prescriptive authority). Training in suicide assessment, treatment, and management: a one-time requirement of 6 contact hours (registered nurses, which includes certified nurse-midwives through the underlying registered nurse license. The rule's only exception is for registered nurses holding an active certified registered nurse anesthetist license, so a nurse-midwife is not excepted). Health equity continuing education: 2 contact hours every renewal cycle (all nurses, at each annual registered nurse license renewal). Best practices in the prescribing of opioids: a one-time requirement of 4 contact hours (certified nurse-midwives licensed to prescribe opioids). Telemedicine training: required (nurses who provide clinical services through telemedicine); the board does not state how often.
Washington Certified Nurse-Midwife renewal and continuing education rules
"Not stated" means the board's pages and rules we read do not address it. We do not fill in typical values.
| Renewal cycle | Two-year (24 months) |
|---|---|
| Renewal deadline | Tied to the licensee's birth date |
| Continuing education required | Yes |
| Hours per cycle | 30 contact hours |
| Self-study or online cap | No cap stated |
| Carryover to next cycle | Not stated |
| First renewal exempt | Not stated |
Washington runs two clocks side by side and the nurse-midwife is on both. The advanced practice clock is biennial: WAC 246-840-360(1)(c) requires thirty contact hours of continuing education obtained during the renewal period in each ARNP designation, and WAC 246-840-361 adds that those hours must be acceptable to the certifying body identified in WAC 246-840-302(3), must come from courses whose contact hour is at least fifty minutes, must not include the fifteen prescriptive authority hours, and must not include the same course taken more than once in a cycle. The registered nurse clock is annual and separate: WAC 246-840-220(2) requires a minimum of 96 hours of active nursing practice and a minimum of eight hours of continuing nursing education, of which at least two must be health equity training, within the twelve months before each renewal of the registered nurse license. Neither figure replaces the other, so a nurse-midwife owes both. On top of the thirty, a nurse-midwife with prescriptive authority owes fifteen contact hours of continuing education in pharmacotherapeutics related to the licensee's scope of practice each renewal period under WAC 246-840-450(1)(b), and WAC 246-840-361(3) is explicit that those fifteen hours cannot be counted inside the thirty. So a prescribing nurse-midwife's biennial advanced practice total is forty five contact hours, alongside eight hours a year on the registered nurse license. Certification is also a hard renewal condition rather than a substitute for hours: WAC 246-840-360(1)(b) requires current certification from a certifying body identified in WAC 246-840-302, WAC 246-840-302(3)(b) names the American Midwifery Certification Board as that body for the CNM designation, and WAC 246-840-302(2) states that an ARNP license becomes invalid when the certification expires. A nurse who is enrolled in, or has completed prerequisite classes for, an advanced nursing education program is exempt from the registered nurse continuing competency requirements during that review period under WAC 246-840-220(4).
Required CE topics for Washington certified nurse-midwifes
State-specific subject mandates. Where a mandate applies only to some licensees, the scope is listed.
| Topic | Hours | Frequency | Applies to | Citation |
|---|---|---|---|---|
| Pharmacotherapeutics continuing education for ARNP prescriptive authorityFifteen contact hours during the renewal period in pharmacotherapeutics related to the licensee's scope of practice, declared in writing on the commission's form. The hours must relate to the ARNP's scope of certification and scope of practice, must come from courses whose contact hour is at least fifty minutes, and the same course counts only once in a cycle. WAC 246-840-361(3) states these fifteen hours are in addition to and may not be counted inside the thirty hours required for ARNP license renewal. | 15 contact hours | Every renewal | Certified nurse-midwives who hold ARNP prescriptive authority | WAC 246-840-450(1)(b) and WAC 246-840-451 |
| Training in suicide assessment, treatment, and managementA one-time six-hour training from a qualified suicide prevention training program, which must be on the Department of Health model list required under RCW 43.70.442. It must be completed by the end of the first full year of licensure, and the hours count toward the eight hour annual continuing nursing education requirement in WAC 246-840-220(2)(b). This is the one place the nurse-midwife parts company with the Washington nurse anesthetist: WAC 246-840-220(3)(a) excepts only registered nurses holding an active certified registered nurse anesthetist license. | 6 contact hours | One time | Registered nurses, which includes certified nurse-midwives through the underlying registered nurse license. The rule's only exception is for registered nurses holding an active certified registered nurse anesthetist license, so a nurse-midwife is not excepted | WAC 246-840-220(3) |
| Health equity continuing educationA minimum of two hours of health equity continuing education every year on registered nurse license renewal. The training must include implicit bias training to identify strategies to reduce bias during assessment and diagnosis, trainers with demonstrated knowledge and experience related to health equity, and a course that assesses the ability to apply health equity concepts in practice. It must be completed by the second full continuing education reporting period after initial licensure or the 2026 renewal, whichever is later, and after that first reporting period within the twelve months before renewal. Additional hours cannot be rolled over to the following year. The hours count toward the eight hour annual requirement. | 2 contact hours | Every renewal | All nurses, at each annual registered nurse license renewal | WAC 246-840-222 |
| Best practices in the prescribing of opioidsWAC 246-840-4655(1) describes this as a one-time continuing education requirement of at least four hours, due by the end of the first full continuing education reporting period after January 1, 2019 or after initial licensure, whichever is later. The four hour course may count toward any Nursing Care Quality Assurance Commission required continuing education. A chronic pain management specialist must also meet the separate requirements in WAC 246-840-493. | 4 contact hours | One time | Certified nurse-midwives licensed to prescribe opioids | WAC 246-840-4655 |
| Telemedicine trainingWAC 246-840-220(5) says a nurse providing clinical services through telemedicine shall complete requirements under RCW 43.70.495. The rule states no hour count and no frequency, and the statute itself was not read, so both are left null. | Not stated | Frequency not stated | Nurses who provide clinical services through telemedicine | WAC 246-840-220(5), referring to RCW 43.70.495 |
Documentation and audit
| Proof submitted at renewal | No, attestation only |
|---|---|
| Keep records for | Not stated |
| Board audits compliance | Yes |
| Approved providers | Advanced practice continuing education must be acceptable to the certifying body identified in WAC 246-840-302(3), which for a nurse-midwife is the American Midwifery Certification Board, and must come from courses in which a contact hour is at least fifty minutes. Suicide prevention training must be from a program on the Department of Health model list required under RCW 43.70.442. |
Common questions
- How many CE hours does a Washington CNM need to renew?
- Washington nurse-midwives must complete 30 contact hours of continuing education every two years to renew their license with the Washington State Board of Nursing (Nursing Care Quality Assurance Commission). Washington runs two clocks side by side and the nurse-midwife is on both. The advanced practice clock is biennial: WAC 246-840-360(1)(c) requires thirty contact hours of continuing education obtained during the renewal period in each ARNP designation, and WAC 246-840-361 adds that those hours must be acceptable to the certifying body identified in WAC 246-840-302(3), must come from courses whose contact hour is at least fifty minutes, must not include the fifteen prescriptive authority hours, and must not include the same course taken more than once in a cycle. The registered nurse clock is annual and separate: WAC 246-840-220(2) requires a minimum of 96 hours of active nursing practice and a minimum of eight hours of continuing nursing education, of which at least two must be health equity training, within the twelve months before each renewal of the registered nurse license. Neither figure replaces the other, so a nurse-midwife owes both. On top of the thirty, a nurse-midwife with prescriptive authority owes fifteen contact hours of continuing education in pharmacotherapeutics related to the licensee's scope of practice each renewal period under WAC 246-840-450(1)(b), and WAC 246-840-361(3) is explicit that those fifteen hours cannot be counted inside the thirty. So a prescribing nurse-midwife's biennial advanced practice total is forty five contact hours, alongside eight hours a year on the registered nurse license. Certification is also a hard renewal condition rather than a substitute for hours: WAC 246-840-360(1)(b) requires current certification from a certifying body identified in WAC 246-840-302, WAC 246-840-302(3)(b) names the American Midwifery Certification Board as that body for the CNM designation, and WAC 246-840-302(2) states that an ARNP license becomes invalid when the certification expires. A nurse who is enrolled in, or has completed prerequisite classes for, an advanced nursing education program is exempt from the registered nurse continuing competency requirements during that review period under WAC 246-840-220(4).
- How often does a Washington CNM license need to be renewed?
- Certified Nurse-Midwife licenses in Washington renew every two years. The advanced registered nurse practitioner license, which is the license a Washington nurse-midwife holds under the certified nurse-midwife designation, renews every other year on the licensee's birthday. The underlying registered nurse license renews every year on the same birthday, so a nurse-midwife files a registered nurse renewal in the off years and both renewals in the on years. Renewal is completed in the HELMS portal with an attestation that the renewal requirements were met. Prescriptive authority, for a nurse-midwife who holds it, is renewed at the same time as the ARNP license, and a nurse-midwife who lets prescriptive authority expire may not prescribe until it is renewed.
- What specific CE topics are required for Washington nurse-midwives?
- Pharmacotherapeutics continuing education for ARNP prescriptive authority: 15 contact hours every renewal cycle (certified nurse-midwives who hold ARNP prescriptive authority). Training in suicide assessment, treatment, and management: a one-time requirement of 6 contact hours (registered nurses, which includes certified nurse-midwives through the underlying registered nurse license. The rule's only exception is for registered nurses holding an active certified registered nurse anesthetist license, so a nurse-midwife is not excepted). Health equity continuing education: 2 contact hours every renewal cycle (all nurses, at each annual registered nurse license renewal). Best practices in the prescribing of opioids: a one-time requirement of 4 contact hours (certified nurse-midwives licensed to prescribe opioids). Telemedicine training: required (nurses who provide clinical services through telemedicine); the board does not state how often. Citations: pharmacotherapeutics continuing education for ARNP prescriptive authority (WAC 246-840-450(1)(b) and WAC 246-840-451), training in suicide assessment, treatment, and management (WAC 246-840-220(3)), health equity continuing education (WAC 246-840-222), best practices in the prescribing of opioids (WAC 246-840-4655), and telemedicine training (WAC 246-840-220(5), referring to RCW 43.70.495).
- Do Washington nurse-midwives have to submit CE certificates at renewal?
- Licensees attest to completion at renewal rather than submitting certificates and the board audits a sample of renewals and asks for documentation. Advanced practice continuing education must be acceptable to the certifying body identified in WAC 246-840-302(3), which for a nurse-midwife is the American Midwifery Certification Board, and must come from courses in which a contact hour is at least fifty minutes. Suicide prevention training must be from a program on the Department of Health model list required under RCW 43.70.442.
Sources
Last verified September 10, 2026. Every value above was read from one of these.
- WAC 246-840-302, ARNP designations, certification, and approved certification examinationsStatute or administrative rule, accessed September 10, 2026
- WAC 246-840-360, Renewal of ARNP licensureStatute or administrative rule, accessed September 10, 2026
- WAC 246-840-361, Continuing education for ARNP license renewalStatute or administrative rule, accessed September 10, 2026
- WAC 246-840-450, Renewal of ARNP prescriptive authorityStatute or administrative rule, accessed September 10, 2026
- WAC 246-840-451, Continuing education requirements for ARNP prescriptive authorityStatute or administrative rule, accessed September 10, 2026
- WAC 246-840-220, Continuing competency requirements, active statusStatute or administrative rule, accessed September 10, 2026
- WAC 246-840-222, Continuing competency requirements, health equity continuing educationStatute or administrative rule, accessed September 10, 2026
- WAC 246-840-4655, Continuing education requirements for opioid prescribingStatute or administrative rule, accessed September 10, 2026
- RCW 18.50.005, definitions in the midwifery chapter (the separate licensed midwife credential)Statute or administrative rule, accessed September 10, 2026
- License renewal, Washington State Board of NursingState board page, accessed September 10, 2026
Washington has a distinct nurse-midwife credential and the regulator is the nursing board, the common pattern: WAC 246-840-302(1)(b) lists certified nurse-midwife (CNM) as one of the four ARNP designations the commission recognizes, alongside nurse practitioner, certified registered nurse anesthetist and clinical nurse specialist. The rule was established as governing the nurse-midwife rather than another kind of midwife by WAC 246-840-302(3)(b), which names the American Midwifery Certification Board as the certifying body for the CNM designation, a certification only a nurse-midwife can hold. Washington separately licenses midwives who are not nurses under RCW chapter 18.50 through the Department of Health, and RCW 18.50.005(4) defines a midwife as a midwife licensed under that chapter while treating the advanced registered nurse practitioner as a different thing; none of chapter 18.50 is recorded here. AMCB certification is a hard renewal condition, not a substitute for hours: it is required by WAC 246-840-360(1)(b) and (2)(b), and WAC 246-840-302(2) states the ARNP license becomes invalid when the certification expires. Per the brief's rule, no AMCB Certificate Maintenance Program total is recorded in hours_per_cycle. On the layering question the brief flagged for this state: Washington runs genuinely parallel clocks. The thirty ARNP hours are biennial and per designation; the eight registered nurse hours with two health equity hours and 96 practice hours are annual; the fifteen pharmacotherapeutics hours are biennial and explicitly outside the thirty under WAC 246-840-361(3). On the specific question about the suicide prevention exception: WAC 246-840-220(3)(a) excepts only registered nurses holding an active certified registered nurse anesthetist license, so a nurse-midwife is covered by the one-time six-hour requirement, not excepted. Two effective date checks were made. WAC 246-840-220 and WAC 246-840-222 were both last amended by WSR 26-02-031, filed December 30, 2025 and effective January 30, 2026, so the text recorded here is the version now in force. Separately, RCW 18.50.005 carries a reviser's note that the term advanced registered nurse practitioner was changed to advanced practice registered nurse by 2024 c 239 s 1 effective June 30, 2027; that is a naming change with a future effective date and does not alter any requirement recorded here, so no advisory is set. One disagreement with existing Washington records should be resolved by whoever maintains them. wa-np and wa-crna both record the four hour opioid prescribing requirement with frequency every_cycle. WAC 246-840-4655(1) calls it a one-time continuing education requirement and WAC 246-840-4655(2) sets a single deadline tied to the first full reporting period after January 1, 2019 or after initial licensure, so this record uses one_time. Otherwise this record agrees with wa-crna on the thirty hour biennial ARNP figure, the fifteen pharmacotherapeutics hours, the two hour annual health equity requirement and the birthday cycle, and differs from it only on suicide prevention, where the rule's exception does not reach a nurse-midwife.
Provided for general reference. Requirements change through legislative sessions and rulemaking, so confirm with the Washington State Board of Nursing (Nursing Care Quality Assurance Commission) before relying on them for a renewal. Spot something out of date? Tell us and we will fix it.