Selling a Medical or Aesthetic Practice in Washington

Washington bans the corporate practice of medicine through common law, not an express statute. Courts built the doctrine by interpreting the state medical-practice law, with Morelli v. Ehsan and Washington Imaging Services as the cited cases. A business entity may not employ physicians to practice medicine, and a non-physician may not own the clinical side of a medical practice or med spa. Washington courts look past the paperwork and scrutinize how much control the management company actually exercises over the professional entity and the payment scheme between the two. A management company that crosses into patient or clinical care is not permitted. The Washington Department of Health adds enforcement points: prohibitions on fee-splitting and on aiding the unlicensed practice of a profession, a required medical director, and prescription-device use, such as lasers, only under physician supervision.

It tried, and the restrictive bill did not become law. In January 2026 the legislature introduced Second Substitute Senate Bill 5387 to codify and sharply tighten the corporate-practice ban. It would have required professional corporations to be owned only by medical licensees, barred those licensees from owning shares in or directing a contracted management company, and restricted transfer of control to non-licensees, with a proposed effective date of January 1, 2027. That bill failed to advance from the Senate in late March 2026. So as of this writing the restrictive bill is not law. The implied common-law ban plus the MSO and friendly-PC model remains the operative reality, but the recent legislative push signals real intent to restrict private-equity-style structures, and a buyer will price that risk.

No. There is no published Washington-specific multiple, and we will not quote one. What we use is the national vertical range for your practice type, then we explain how Washington law and market move structure and value. A state does not have its own multiple. What Washington does is shape deal structure, because the implied corporate-practice ban forces value through a management-company economic model rather than a clean equity sale. A practice with a defensible management agreement and a durable friendly-PC relationship holds its value. A practice without one invites re-trading and discounts. Your real number comes from a confidential, practice-specific analysis.

Demand is national, and there is documented financial-buyer activity inside Washington. The Washington Office of the Insurance Commissioner’s January 2026 report, using PitchBook data, recorded 22 dermatology private-equity acquisitions in the state since 2021 and 44 between 2015 and 2024, with roughly 2.73 billion dollars in dermatology deal value. The report’s list of the most acquisitive platforms includes Advanced MedAesthetic Partners, backed by Leon Capital Group, which is a national medical-aesthetics platform that buys med spas, plastic-surgery, and cosmetic-dermatology practices. National vertical consolidators active as acquirers include U.S. Dermatology Partners, Forefront Dermatology, QualDerm and Pinnacle Dermatology, Epiphany Dermatology, Schweiger Dermatology, Aqua Dermatology, and AYA Medical Spa. The accurate picture is well-capitalized national platforms and PE-backed management companies buying in Washington, not a single local acquirer.

Washington is a smaller, Seattle-anchored aesthetic market. AmSpa’s State of the Medical Spa Industry report publishes a national med spa count only, with no state-by-state breakdown or ranking, so we will not cite an uncitable Washington figure. What is verifiable is buyer activity: the Washington Office of the Insurance Commissioner’s January 2026 report independently confirms a deep, active buyer base by documenting 22 dermatology private-equity deals in the state since 2021.

Yes, unless and until you choose to tell people. We run every process under strict confidentiality, with confidentiality agreements, secure data rooms, staged disclosure, and a vetted buyer process. Premature disclosure can unsettle staff, shake patient confidence, and weaken your negotiating position, so you decide what is shared, with whom, and when. Because a Washington deal runs through a management-company and friendly-PC structure, we plan that structure openly with you so confidentiality and compliance hold together through close.