# PELVIC WELLNESS CENTER OF SALEM

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689130270
- **Authorized official:** SHANNON FORRESTALL PT (OWNER)
- **Authorized official phone:** (503) 551-1099

## Contact information

- **Practice address:** 1655 CAPITOL ST NE, SALEM, OR 97301-7845
- **Practice address phone:** (503) 551-1099
- **Practice address fax:** (503) 364-1376
- **Mailing address:** 1655 CAPITOL ST NE, SALEM, OR 97301-7845

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 02/19/2019
- **Last updated:** 06/11/2019