About 100 people were transferred to hospitals after most of the Amtrak train's carriages left the track.
A number of those injured are reported to be in a critical condition.
Authorities said all carriages had now been searched, but would not rule a rise in the number of dead.
Seven vehicles, two of them lorries, were hit on the I-5 highway below. It was not clear if anyone was hurt on the road itself.
It was Amtrak's first passenger service to run on a new, shorter route.
Train 501 had left Seattle, heading south for Portland, at 06:00 local time (14:00 GMT). The derailment happened on a section of track, south of Tacoma, previously only used for freight trains.
Authorities quoted by Associated Press earlier spoke of at least six people killed.
Media captionPassenger describes the train crash: 'We could feel cars crumpling'
One passenger carriage could be seen dangling from the bridge, while others were strewn across the road and the wooded area next to the track.
A photograph released by Washington State Patrol showed one carriage upside down on the road, with wreckage all around it.
An Amtrak spokeswoman said the train had derailed at 07:33 local time (15:33 GMT).
There were 77 passengers and seven Amtrak crew members on board, she said.
- BBC-
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