Licensure in naturopathic medicine  is required in order to practice in Washington state.  To obtain licensure, it is required to complete a naturopathic medical degree from an accredited university and pass the state board exam (NPLEX).

Licensure in Washington state allows naturopathic physicians to be primary care providers.  Naturopathic physicians are trained to use standard diagnostic tools including physical examination, laboratory tests, and imaging.  NDs may utilize additional physical and laboratory procedures to assess nutritional status, metabolic function, and/or toxic load, while considerable time may also be spent assessing mental, emotional, social and spiritual status to assure any treatment plan is comprehensive.

NDs use a variety of therapies to promote health and treat disease including: dietetics, therapeutic nutrition, botanical medicine, physical medicine, naturopathic manipulative therapy, lifestyle counseling, exercise therapy, homeopathy, psychological and family counseling, and hydrotherapy. NDs can perform minor office procedures appropriate to a primary care setting, administer vaccinations, and prescribe most standard drugs when indicated. Like other primary doctors, NDs delegate to nurses and medical assistants and refer to specialists when appropriate.

Source: American Association of Naturopathic Physicians