Washington CNA Requirements for Foreign-Trained Nurses

A nurse trained outside the United States can become a Nursing Assistant-Certified (NA-C or NAC) in Washington, and for many internationally educated nurses it is the fastest way to start earning in healthcare while the much longer RN licensure process runs. There are two practical paths. The first is to ask the Washington State Board of Nursing (WABON) whether your nursing education qualifies you to test without repeating nursing assistant training, under the eligibility routes that cover nursing program graduates. The second is to enroll in an approved Washington program, such as the 4-week, 108-hour CNA Traditional course at Huduma CNA Programs, which makes you eligible with no question about foreign transcripts. Either way, you take the same two-part exam ($100 skills test plus $55 Credentia knowledge test) and apply to the Department of Health (DOH) for the credential.

Why foreign-trained nurses choose the NA-C first

Getting a Washington RN license with a foreign degree involves credential evaluation, English testing for most applicants, and the NCLEX. That sequence commonly takes a year or more. The NA-C, by contrast, can be earned in weeks. Hospitals, skilled nursing facilities, and home health agencies across the Puget Sound region hire nursing assistants continuously, and the job places you inside the US care system you will later work in as a nurse.

The financial case is also clear. Job-posting data puts the Washington nursing assistant average at roughly $23.62 per hour (approximate, August 2026), well above the 2026 state minimum wage of $17.13. See CNA salary in Washington State for city-level figures.

The two paths compared

The decision rule most advisers use: if you already have official, translated transcripts in hand and are not in a hurry, ask WABON first. If you need to be working within two months, or your documents are hard to obtain, take the program.

Path 1: Eligibility based on your nursing education

Washington lists nine eligibility routes (E1 through E9) for the nursing assistant exam and credential. Two of them are relevant to nurses:

• E2, nursing student or graduate. Written for students and graduates of LPN and RN programs. It is most straightforward when the program is one WABON already recognizes.
• E4, out-of-state nursing assistant or nursing program graduate. Written for people trained outside Washington.

Whether a nursing program outside the United States satisfies either route is a determination WABON makes on the documents you provide. Do not assume. Contact WABON in writing before you spend money on translations, describe your degree (diploma, associate, or bachelor level, year of graduation, country), and ask which route and which documents apply. Keep the reply; DOH may ask for it later.

Documents WABON and DOH commonly require for education-based routes include official transcripts sent from the school, proof of graduation, and, for non-English documents, certified English translations. If a third-party evaluation of your credentials is requested, expect additional weeks and fees.

What happens if your education is accepted

You skip training and move straight to testing. Because no Washington training program is administering your skills test, you schedule Part 1 through WABON's online scheduling system at a test site that accepts outside candidates. Questions about skills testing go to nac.exam@doh.wa.gov. After the skills pass is recorded, you register for the knowledge test with Credentia. Our step-by-step guide to registering for the Washington CNA exam covers both parts.

Be honest with yourself about the skills test. It is scored on specific critical steps in the American nursing assistant style, and experienced nurses from other systems often fail on details: hand hygiene sequence, explaining every step aloud, checking water temperature, or locking wheelchair brakes. Many self-scheduled candidates pay for a mock skills session before test day; see mock skills testing for the Washington CNA exam.

Path 2: Complete a Washington-approved program

This is the certain path. Approved programs must deliver at least 108 hours under WAC 246-841A-440, taught by licensed nurses with recent direct-care experience. Graduates test under route E1, and the program administers the skills test itself.

What a foreign-trained nurse gets out of the program that a document review cannot provide:

1. Hands-on time with US equipment and documentation in a licensed nursing facility during the 40 clinical hours.
2. Direct practice of every tested skill in the 33-hour lab, with instructors who know exactly what evaluators score.
3. Mock testing on site, so your first attempt is not your first exposure to the format.
4. Employer contact. Clinical placements are a hiring channel; facilities often offer positions to students who perform well.

Admission requires a high school diploma or GED (a foreign secondary credential generally satisfies this; bring documentation), a background check before clinical placement, and English proficiency sufficient for instruction and charting. Instruction is in English. Class dates and the day and weekend patterns are on the schedules page.

English, the exam, and the oral option

Both exam parts are in English. The knowledge test is available in an oral format, in which the questions are read aloud, for candidates who understand spoken English better than written English. The oral version is not a translation. If you can read clinical English comfortably, the standard written test is usually faster. Details are in our article on the oral CNA exam in Washington.

Neither WABON nor DOH requires a separate English test such as IELTS for the nursing assistant credential. That requirement belongs to RN licensure.

Background check and the DOH application

Every applicant completes a name-based Washington background check through DOH. If you have lived in Washington only briefly, DOH may require a fingerprint-based check, which takes longer. Disclose any conviction accurately; a conviction is not an automatic bar, but an undisclosed one is treated as dishonesty. Our Washington CNA background check article explains what is reviewed.

The DOH application asks for a Social Security number. If you have never been issued one, DOH provides a way to state that on the application rather than leaving it blank; you do not need citizenship or permanent residence to hold the credential. Employers separately verify work authorization at hire. Fees for the application and annual renewal follow the current DOH fee schedule.

Working while your RN application is pending

Once certified, a foreign-trained nurse working as a NA-C should keep three things in mind:

• Scope of practice. You may only perform nursing assistant tasks and nurse-delegated tasks, even if you performed far more in your home country. Acting beyond scope is grounds for discipline against the NA-C and can affect a future RN application.
• Renewal. The NA-C renews every year on your birthday through the DOH portal, with no continuing education for a standard credential.
• Employer support. Large systems such as UW Medicine, Providence, MultiCare, and Virginia Mason Franciscan hire nursing assistants and some offer tuition support or NCLEX preparation to employees pursuing RN licensure. Ask during interviews.

Many nurses find that the clinical exposure of nursing assistant work is the most effective preparation for the NCLEX because it grounds test questions in US practice.

Frequently asked questions

Can a foreign nursing degree exempt me from CNA training in Washington? Possibly. Routes E2 and E4 cover nursing program graduates, but whether a program outside the United States qualifies is decided by WABON on your documents. Ask before you apply.

What if WABON says my education does not qualify? Enroll in an approved program. The 4-week, 108-hour CNA Traditional course at Huduma makes you eligible under route E1 with no transcript review.

Do I need a credential evaluation service for the NA-C? Only if WABON or DOH asks for one to support an education-based route. The program route never requires it.

Is the exam offered in my language? No. Both parts are in English. The knowledge test has an oral (read-aloud) English format.

Will working as a CNA hurt my RN application? No. Working within scope is not a problem and gives you documented US clinical experience. Working beyond scope can hurt it.

How much does the whole process cost through the program route? $1,100 tuition, about $105 for books and supplies, $155 for the two exam parts, plus DOH application and background check fees per the fee schedule.

To compare the two Huduma programs, read CNA Traditional vs HCA–CNA Bridge; the bridge applies only if you already hold an active Washington Home Care Aide credential. Program details are on the CNA Traditional page.