Regulates developers and deployers of high-risk AI systems used to make or substantially factor in consequential decisions affecting Washington consumers across domains including employment, housing, credit, healthcare, education, insurance, and legal services. Developers must provide deployers with documentation on intended uses, bias risks, performance evaluations, and mitigation measures, and must label synthetic content generated by high-risk generative AI systems. Deployers must implement risk management programs, complete impact assessments before deployment, disclose AI use to consumers before consequential decisions, explain adverse decisions, and publicly summarize their algorithmic discrimination risk management approach. Compliance with NIST AI RMF or ISO/IEC 42001 creates a rebuttable presumption of conformity. Enforcement is through private right of action with injunctive relief and attorneys' fees; an affirmative defense exists for entities that discover, cure within 45 days, and provide notice. Broad carve-outs exist for insurers, financial institutions subject to existing AI regulation, HIPAA-covered telemedicine providers, and federally approved AI systems.