Lavender Moon Wellness LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

LAVENDER MOON WELLNESS LLC

Doing business as

Lavender Moon Wellness
Unfurl Center

Practice address

2933 NE Broadway St
Portland, OR 97232-1760

Phone

(503) 960-3366

NPI assigned

May 30, 2024

Organization subpart

No

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

Authorized official

Name

Samantha M Paquette, LMT

Title

Owner

Phone

(503) 960-3366

Specialties & licenses 1

Addresses

Other names 2

• Lavender Moon Wellness Doing business as
• Unfurl Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samantha Marie Paquette, LMT

  • Massage Therapist
  • Portland, OR
  • NPI 1447700174
  NPD

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1619717170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2933 NE BROADWAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321760",
            "telephone_number": "503-960-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2933 NE BROADWAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321760",
            "telephone_number": "503-960-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVENDER MOON WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "M PAQUETTE",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-960-3366",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lavender Moon Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Unfurl Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chelsea Lavalley
• Brooke Lavarias
• Maia Lavarias, PA
• Kelsey Marie Lavaute, DPT
• Mary Bernadette Lavelle, RN, MSN
• Taylor Lavender, PMHNP-BC
• Robert Alan Laver, C.P.O.
• Emma Lavetter-Keidan, CSWA
• Katherine Lavie
• Brenda Ann Lavigne, PA-C

• Massage Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.