Individual provider Active NPI

Amanda L. Lugo, PAC

  • Surgical Physician Assistant
  • Enumclaw, WA
National Provider Identifier
1780062034
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA70012203 Issued in WA
Practice address
2820 Griffin Ave Ste 210
Enumclaw, WA 98022-2373
Phone
(360) 825-7500
Fax
(360) 825-3370
NPI assigned
May 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA70012203 WA Primary
Athletic Trainer 2255A2300X

Addresses

Primary practice location

2820 Griffin Ave Ste 210
Enumclaw, WA 98022-2373

Mailing address

2820 Griffin Ave Ste 210
Enumclaw, WA 98022-2373
Phone (360) 825-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260106003750 WA Practitioner - Physician Assistant 2264928597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

2820 Griffin Ave
Suite 210
Enumclaw, WA 98022-2373
Phone (360) 825-7500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA70012203WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Dec 15, 2025 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

2820 Griffin Ave
Ste 210
Enumclaw, WA 98022
Phone (360) 802-6838

2820 Griffin Ave
Ste 210A
Enumclaw, WA 98022

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1780062034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 GRIFFIN AVE STE 210",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980222373",
            "telephone_number": "360-825-7500",
            "fax_number": "360-825-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 GRIFFIN AVE STE 210",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980222373",
            "telephone_number": "360-825-7500",
            "fax_number": "360-825-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUGO",
        "first_name": "AMANDA",
        "middle_name": "L.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-07",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA70012203",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enumclaw, WA

Sources for this page

Verify at the official NPI Registry.