The collision occurred around 4:15 p.m. about one mile east of Index when a westbound car crossed the centerline and struck a Ford F-250 pickup truck, Washington State Patrol trooper Mark Francis said.
The accident tied up traffic for hours. The road was reopened at about 8:30 p.m.
The driver of the car, a four-door Mercedes, died at the scene. The car reportedly was being driven erratically before the collision, Francis said.
His passenger, a pregnant woman, was taken to a hospital with serious injuries, he said.
Three men in the pickup truck also were taken to hospitals.
Names, ages and hometowns of the people involved in the crash were not immediately available.
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