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The institution was established
in 1909 on a tract of land at Sedro-Woolley and was originally a farm for harmless patients under the direction of the superintendent of the Western Hospital at Fort Steilacoom. In 1911 the hospital was separated from the Western Hospital and quickly became the largest in the state. The new hospital opened April 1, 1911. Dr. A. H. McLeish was the first superintendent. He served until August 5, 1913 when he resigned and was succeeded by Dr. W. E. Cass. On February 1, 1914, Dr. Cass was succeeded by superintendent, Dr. J. W. Doughty, who was promoted from the position of first assistant physician at the Western Hospital for the Insane.