Medical & Dental Practices Bookkeeping in Washington

Employer registration in Washington runs through the Washington Employment Security Department, a different agency from the Washington Department of Revenue that handles your sales tax — a separate account number, a separate login, and separate deadlines. Businesses routinely register for one and forget the other, then discover the gap when a notice arrives.

Registering to do business in Washington runs through the Washington Secretary of State, with tax accounts through the Washington Department of Revenue and employer accounts through the Washington Employment Security Department. Washington treats these as wholly independent, so being in good standing with one says nothing about the others — and the sales tax account is the one that accrues a real balance while you are not looking.

Beyond sales tax, Washington entities have their own obligations — registration with the Washington Secretary of State, and whatever annual entity-level tax or report the state imposes. No income tax, but the Business and Occupation tax applies to gross receipts by activity classification and is reported alongside sales tax. These are recorded as they accrue rather than discovered at year end.

Whether medical & dental practices services are taxable in Washington is the question that catches people out — states differ enormously, and several have been broadening what counts. No income tax, but the Business and Occupation tax applies to gross receipts by activity classification and is reported alongside sales tax. We code service revenue separately from any product revenue so the treatment is explicit rather than assumed.