| 1 | Gates Foundation Trust Kirkland | T | $231.7B | $0 | $77.6B |
| 2 | Pivotal Philanthropies Foundation Redmond | T | $17.4B | $0 | $7.4B |
| 3 | Providence Health & Services Washington Renton | E | $9.8B | $9.7B | $9.3B |
| 4 | Gates Foundation Seattle | T | $8.2B | $0 | $78.7B |
| 5 | Kaiser Foundation Health Plan of Washington Renton | E | $6.6B | $4.4B | $3.2B |
| 6 | Providence Health & Services Oregon Seattle | E | $6.2B | $5.9B | $4.7B |
| 7 | Peacehealth Vancouver | E | $5.9B | $3.6B | $4.8B |
| 8 | Multicare Health System Tacoma | E | $5.0B | $5.0B | $6.3B |
| 9 | Providence Health Plan Renton | Z | $3.7B | $2.6B | $1.2B |
| 10 | Swedish Health Services Renton | E | $3.4B | $3.3B | $3.7B |
| 11 | Seattle Childrens Hospital Seattle | E | $2.9B | $2.7B | $5.6B |
| 12 | Fred Hutchinson Cancer Center Seattle | E | $2.8B | $2.0B | $3.5B |
| 13 | Providence Health System-southern California Seattle | E | $2.4B | $2.3B | $3.5B |
| 14 | Pivotal Philanthropies Opportunity Foundation Redmond | T | $2.3B | $0 | $962.6M |
| 15 | Pivotal Philanthropies Momentum Foundation Redmond | T | $2.3B | $0 | $962.6M |
| 16 | World Vision Federal Way | Q | $2.3B | $1.6B | $506.6M |
| 17 | Delta Dental of Washington Seattle | E | $1.9B | $1.8B | $258.7M |
| 18 | Allen Family Philanthropies Seattle | T | $1.9B | $0 | $1.4B |
| 19 | Franciscan Health System Tacoma | E | $1.8B | $1.8B | $1.2B |
| 20 | Chp of Washington Seattle | E | $1.7B | $1.6B | $498.6M |
| 21 | Overlake Medical Center & Clinics Bellevue | E | $1.3B | $802.8M | $946.2M |
| 22 | Virginia Mason Medical Center Seattle | E | $1.3B | $1.3B | $1.4B |
| 23 | Kadlec Regional Medical Center Richland | E | $1.1B | $1.0B | $903.7M |
| 24 | Central Washington Health Services Association Wenatchee | E | $954.3M | $914.5M | $808.4M |
| 25 | Operating Engineers Health and Welfare Trust Fund Bothell | Z | $887.3M | $330.6M | $822.2M |
| 26 | The Seattle Foundation Seattle | T | $785.0M | $314.7M | $1.4B |
| 27 | Harrison Medical Center Bremerton | E | $783.6M | $783.6M | $781.2M |
| 28 | Seattle University Seattle | Z | $741.1M | $455.1M | $971.5M |
| 29 | Yakima Valley Memorial Hospital Association Yakima | E | $714.8M | $647.0M | $567.7M |
| 30 | M J Murdock Charitable Trust Vancouver | T | $693.8M | $0 | $2.0B |
| 31 | Legacy Salmon Creek Hospital Vancouver | E | $657.1M | $655.8M | $738.8M |
| 32 | Spokane Teachers Credit Union Liberty Lake | Z | $621.0M | $343.4M | $5.8B |
| 33 | Sea Mar Community Health Centers Seattle | E | $580.4M | $578.2M | $465.0M |
| 34 | Providence Health & Services Mt Seattle | E | $567.8M | $563.3M | $431.8M |
| 35 | Corporation of Gonzaga University Spokane | B | $540.8M | $459.0M | $1.1B |
| 36 | Voluntary Employees Benefit Association Trust for Public Spokane | Y | $507.2M | $129.4M | $651.2M |
| 37 | Association of University Physicians Seattle | B | $504.8M | $465.1M | $334.8M |
| 38 | Providence Saint Johns Health Center Seattle | E | $501.6M | $499.5M | $523.1M |
| 39 | Seiu Healthcare NW Health Benefits Trust Seattle | Y | $484.6M | $375.4M | $479.5M |
| 40 | Marguerite Casey Foundation Seattle | P | $484.6M | $0 | $876.6M |
| 41 | Washington Teamster Welfare Trust Seattle | Z | $469.2M | $376.2M | $399.8M |
| 42 | Franciscan Medical Group Tacoma | E | $462.4M | $462.4M | $219.6M |
| 43 | Middletown Works Hourly & Salaried Union Retirees Health Care Fund Seattle | Y | $454.4M | $92.2M | $680.8M |
| 44 | Christ Cares for Kids Foundation Issaquah | T | $444.8M | $0 | $236.4M |
| 45 | Yakima Valley Farm Workers Clinic Toppenish | E | $422.2M | $396.2M | $336.0M |
| 46 | Tarzana Medical Center LLC Renton | E | $394.8M | $393.5M | $922.6M |
| 47 | Path Seattle | Q | $393.8M | $353.5M | $416.1M |
| 48 | Providence Plan Partners Renton | E | $386.3M | $386.3M | $60.4M |
| 49 | Association of Washington Cities Employees Benefit Trust Olympia | Z | $375.9M | $299.5M | $141.3M |
| 50 | Bezos Family Foundation Seattle | T | $375.8M | $0 | $154.2M |