Washington CNA Eligibility Routes E1–E9 Explained

Washington recognizes nine eligibility routes, labeled E1 through E9, for taking the nursing assistant exam and applying for the Nursing Assistant-Certified (NA-C or NAC) credential. Every route leads to the same two-part exam (a $100 in-person skills test followed by a $55 Credentia knowledge test, $155 total) and the same Department of Health (DOH) application. What differs is the evidence you present to prove you are ready: an approved 108-hour Washington program (E1), nursing or military education (E2, E3), an out-of-state credential or program (E4), retraining after a long lapse (E5), an alternative program such as the HCA bridge (E6), older training (E7), an OBRA competency retest (E8), or graduation from a program that has since closed (E9). This guide explains each route and how to pick yours.

The nine routes at a glance

Two agencies are involved. The Washington State Board of Nursing (WABON, formerly the Nursing Care Quality Assurance Commission) sets the routes and decides borderline cases. DOH issues the credential, runs the background check, and lists you on Provider Credential Search.

Routes for new entrants: E1 and E6

E1 is the route most people use. You complete an approved program meeting WAC 246-841A-440 (at least 108 clock hours), the program administers your skills test on site, and you register with Credentia after the pass is recorded. Huduma CNA Programs in Federal Way runs its CNA Traditional program on this route: 4 weeks, $1,100 tuition, about $105 in books and supplies, day or weekend patterns, high school diploma or GED required.

E6 covers approved alternative programs. The largest group is Home Care Aides. An active Washington HCA credential lets you enter a bridge program (DOH describes a 24-hour bridge; Huduma's runs 40 hours: 36 instructional plus 4 hours of mock testing, $800 tuition) and test under E6. A parallel bridge exists for credentialed medical assistants. Full details are in the HCA to CNA bridge program guide.

Both routes share the strongest practical advantage in the system: the program tests you, so you never wait for an outside test slot, and the program must give you at least four attempts.

Routes based on other education: E2, E3, E4

E2, nursing student or graduate. Students who have completed the nursing assistant content of an approved LPN or RN program (typically the fundamentals course with clinical) and program graduates who have not obtained a nursing license. The nursing program verifies eligibility. See the E2 route for nursing students.

E3, military nursing student. Army medics, Navy corpsmen, Air Force medical technicians, and similar specialties whose training WABON accepts on documentation such as the Joint Services Transcript. See military medics and corpsmen becoming CNAs in Washington.

E4, out-of-state nursing assistant or nursing program graduate. Two groups: people with an active nurse aide credential elsewhere, who apply by endorsement with verification from their state's registry, and graduates of nursing assistant or nursing programs outside Washington, whose documents WABON evaluates. Nurses trained outside the United States often fall here; see Washington CNA requirements for foreign-trained nurses.

For all three, the skills test is self-scheduled through WABON's online system at a test site that accepts outside candidates, with the $100 fee paid to that site. Skills-testing questions go to nac.exam@doh.wa.gov.

Routes for returning nursing assistants: E5, E7, E8, E9

E5, lapsed more than 3 years with retraining. A former Washington NA-C whose credential has been expired for three years or more completes an approved program again and tests as a graduate. Details in lapsed for over three years in Washington.

E7, trained before February 1, 2015. For people who completed nursing assistant training under the rules in place before that date and never certified, or need to establish eligibility from that training. Expect WABON to ask for proof of the training and its dates. Because training that old rarely matches the current skills list, most E7 candidates prepare as if they were new.

E8, OBRA reactivation. A former Washington credential holder required by federal OBRA rules to demonstrate competency again after a gap in paid nursing-related work. One attempt at each part; a fail on either converts you to an E1 or E5 trainee. See OBRA reactivation in Washington.

E9, training program now closed. For graduates of an approved program that no longer operates. Since the program cannot report your completion or test you, WABON relies on the records DOH holds and any documentation you kept. Keep your Certificate of Completion from any program; this route is why.

Decision guide

Work through these questions in order:

1. Do you hold an active Washington HCA credential? Yes: E6 via a bridge program. No: continue.
2. Do you hold an active nurse aide credential in another state? Yes: E4 by endorsement with verification from that state's registry. No: continue.
3. Are you in, or a graduate of, an LPN or RN program? In Washington: E2. Outside Washington or outside the United States: ask WABON about E4. No: continue.
4. Do you have military medical training? Yes: E3, or E1 if records are slow. No: continue.
5. Did you previously hold a Washington NA-C? Expired under 3 years: reactivation, possibly E8 if DOH requires a retest. Expired 3 years or more: E5. No: continue.
6. Did you finish a Washington program before February 1, 2015, or a program that has since closed? E7 or E9. No: continue.
7. None of the above. E1: enroll in an approved program.

Most readers land on E1 or E6. If you qualify for a self-scheduled route but want the certainty of on-site testing and built-in mock practice, E1 remains available to everyone.

What every route has in common

• Same exam. Since October 1, 2023, Part 1 is the skills test and Part 2 is the Credentia knowledge test, taken in that order. Credentia registration opens only after the skills pass is recorded.
• Same application. DOH application with fee per the current DOH fee schedule, name-based background check (fingerprint check possible for recent out-of-state residents), and listing on Provider Credential Search.
• Same credential. The registry does not show which route you used. Renewal is annual on your birthday with no continuing education for a standard NA-C.
• Same provisional option. A nursing facility can hire you as a Nursing Assistant-Registered (NAR) while you complete your route, with four months from hire to finish training and pass the exam.

Frequently asked questions

Which Washington CNA eligibility route is fastest? E6 for active HCAs (a 40-hour bridge at Huduma over five weekdays) and E4 by endorsement for active out-of-state CNAs. For everyone else, E1 at 4 weeks is fast and predictable.

Can I choose route E1 even if I qualify for another route? Yes. Anyone can enroll in an approved program. People on self-scheduled routes sometimes do so to get on-site testing.

Who decides my route? WABON sets the rules and resolves questions; the training program (for E1, E5, E6) or your documents (all other routes) establish which one applies. DOH processes the application.

Does the route affect the exam fee? No. $100 for the skills test and $55 for the knowledge test on every route.

What is the difference between E5 and E8? E5 is retraining after a lapse of three years or more. E8 is a one-attempt retest for a shorter lapse when federal OBRA rules require a competency evaluation.

Where can I see the official list? WABON publishes the routes and the exam candidate handbook; DOH's nursing assistant pages repeat them alongside the application instructions.

For a route-by-route comparison of Huduma's two programs, see the CNA Traditional and HCA–CNA Bridge pages.