Eight of the residents were taken to a hospital to be treated for respiratory problems, according to fire department officials.
The fire broke out just after 6 a.m. at Life Manor Assisted Living at 1601 South Union Avenue.
Firefighters arrived to find smoke from the kitchen fire creeping into the halls and residence areas.
Jim Molin was in his 6th floor unit when he woke up to the fire alarm and saw the kitchen building on fire.
"I opened the window very quickly and saw the kitchen fire area fully involved," Molin said.
Some residents climbed down the fire escape to get out, Molin said, but for those unable to get out on their own, firefighters carried them to safety.
"There's a lot of people who were immobile who had to be carried out," said Richard Grautas, who lives in the center.
That made fighting the fire even more difficult.
"When you have to divide your resources to move patients as well, it becomes a big challenge," said Jim Zuluaga with the Tacoma Fire Department.
Everyone was taken into a gymnasium at the nearby Life Center Church, where they were given food and warm drinks.
"Just very grateful that I and my neighbors were able to evacuate," Molin said.
Officials said they are looking for temporary housing for all 150 residents while they air out and repair the building.
The kitchen and dining area were destroyed in the fire, but the cause was not known.