Everyone who wants to match in radiology (or anything else competitive, for that matter) needs to be ready to make a case for themselves. The case above is not a very good one. That is, 230 is an OK score, but not impressive in and of itself. Grades in first two years are nice, but not a big factor. A nice letter is good; is it from someone the candidate has actually worked with, or a friend of the family? Clinical grades are very important, obviously. Someone with lots of clinical honors is going to be a lot more competitive. Research (which could just mean writing a case reoprt or helping prepare a poster) also adds to the picture.
I'm not saying this person won't match, I'm just saying they need to prepare their application well so it's obvious to programs that they're a good bet. Iserson's Getting Into a Residency has lots of good ideas for how to do that, but the most important piece of advice in there is to get a good advisor. (Perhaps the person writing the LOR from GW could help?)
As for matching in a particular region goes... most radiology applicants target a region, but the process is very competitive right now, so most have to apply broadly. Definitely make sure the regional ties to the MD/DC area are obvious on the application, because that can help.
Good luck to your friend.
