The Seattle man is believed to have suffered a medical problem that caused the crash, said trooper Mark Francis with the Washington State Patrol.
The mans wife, 86, also was hospitalized for injuries that werent believed to be life-threatening.
The man was driving a Honda Odyssey and apparently rear-ended a Ford Fusion.
The impact sent the Honda van spinning before it struck a wall and then struck a Chevrolet car, Francis
The Ford driver, a 38-year-old Lynnwood woman, declined an ambulance but later went to the hospital, Francis
The Chevy driver, a 55-year-old Mount Vernon man, was not seriously hurt.
At first, police thought a fourth vehicle had fled the scene as a hit-and-run, but that information was likely to be ruled out as the investigation continued, Francis