Provider Resources: COVID-19


Updated: November 2, 2021

We want to take a moment to thank you for your patience over the past couple of years as we put pieces in place that enabled us to safely care for your patients. Some of these measures remain in place, while others have been fluid to match the needs of the community.

In November, we closed our dedicated imaging site for symptomatic patients at our Diagnostic Imaging Northwest Puyallup Imaging Center. We currently do not offer Chest X-rays for patients with COVID-like symptoms or pending COVID tests.

NOTE: COVID-positive patients needing urgent imaging (prior to 14 days after their COVID test), should be directed tot he hospital. Providers who have questions about the scheduling methodology can contact us at

Updated: February 10, 2021


This communication provides updated guidance from TRA Medical Imaging (TRA) regarding scheduling a screening mammogram or breast MRI during COVID-19 vaccination.

Background: There has been a reported increase in axillary lymphadenopathy following administration of the COVID-19 vaccination. To minimize unnecessary callbacks from screening mammograms, we recommend the following, as advocated by the Society of Breast Imaging (SBI):

SBI considerations for patients and providers scheduling a screening mammogram or breast MRI —

  • If possible, and when it does not unduly delay care, consider scheduling screening exams prior to the first dose of a COVID-19 vaccination or 4-6 weeks following the second dose of a COVID-19 vaccination.

The following guidelines will be followed by TRA for the management of axillary adenopathy in patients with recent COVID-19 vaccination:

  • The TRA patient intake process will include questions regarding COVID-19 vaccination. To minimize patient anxiety, staff will start with the following introductory statement: Vaccines of all types can result in temporary swelling of the lymph nodes, which may be a sign that the body is making antibodies in response as intended.
  • Enlarged lymph nodes seen on screening mammography will be given a BI-RADS 0 assessment.
  • If there is a history of recent Covid-19 vaccination, further diagnostic imaging will be delayed 4-6 weeks after the second or last vaccine dose. Most lymphadenopathy associated with vaccination will resolve during this time.
  • If lymphadenopathy persists after follow-up imaging, percutaneous sampling will be performed to rule out malignancy.
  • If lymphadenopathy is found on clinical exam and there is a history of recent Covid-19 vaccination, consider delaying imaging evaluation until 4-6 weeks after the second or last dose as most lymphadenopathy will resolve during this time.

If you have any questions, please call 253.761.4200 or 360.413.8383 to speak to our team.


We understand habits can be hard to break. We’d like to remind you that one way we are keeping patients safe is by offering scheduled all x-ray exams so that we can practice social distancing in our waiting rooms.

  • X-ray Scheduling at DINW: 253-841-4353
  • X-ray Scheduling at TRA, Pierce County: 253-761-4200
  • X-ray Scheduling at TRA, Thurston County: 360-413-8383

We understand that this epidemic has resulted in anxiety and uncertainty for many. It is important to us that our healthcare partners and patients understand the extra precautions and measures we are taking so everyone can feel confident and SAFE in our care.

S – Social distancing requirements with flexible waiting options
A – Applied universal masking protocol and temperature screening
F – Facility safety enhancements including physical and engineered barriers
E – Enhanced cleaning and disinfecting

Effective April 2, 2020 – TRA will be implementing a universal masking protocol at all of our freestanding outpatient imaging centers, as well as our affiliated imaging facilities – Diagnostic Imaging Northwest and Carol Milgard Breast Center. Learn more about Universal Masking.

In response to the rapid spread of COVID-19, the shortage of available PPE, and the needs of our community, we have established our first dedicated imaging location for symptomatic patients at DINW Mobile Imaging Service.

Here’s what you need to know:

It is imperative that we have the following information documented on the patient’s order:

  1. Screening questions answered (fever, cough, shortness of breath)
  2. Has the patient been tested for COVID-19? If yes, please provide the date of testing.
    1. Positive result – patient must be sent to a higher acuity facility.
    2. Negative – please proceed to DINW Puyallup Imaging Center.


Download Order Forms

Urgent Exam Scheduling

In order to best serve our patients, we have created a dedicated team for handling STAT exams.

Urgent Exam Scheduling should be used for:

  • Scheduling medically urgent studies that should not wait more than a few weeks to be performed
  • The ability to communicate the details or guidelines about when a study needs to be scheduled

Please note: In order for our team to see your STAT patients quickly, we must have a signed order with clinicals.

Urgent Exam Scheduling: 253-680-3395

Plain Film Scheduling for All Locations
Due to the development of our dedicated imaging site for symptomatic patients, we will only be accepting X-rays by appointment-only at all TRA and DINW locations. This will help make sure symptomatic patients are seen at the dedicated imaging facility for symptomatic patients, reducing opportunities for exposure and ensuring all patients are seen in a timely fashion.

TRA Scheduling: 253-761-4200
DINW Scheduling: 253-841-4353

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