# REVIVE INJURY AND WELLNESS, PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Vermillion & Bloom, PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952698680
- **Authorized official:** DR. ERIN DANIELLE BLOOM DC (PRESIDENT)
- **Authorized official phone:** (503) 344-4378

## Contact information

- **Practice address:** 1750 BLANKENSHIP RD, STE 295, WEST LINN, OR 97068-5101
- **Practice address phone:** (503) 344-4378
- **Practice address fax:** (503) 334-3604
- **Mailing address:** 1750 BLANKENSHIP RD, SUITE 295, WEST LINN, OR 97068
- **Mailing address phone:** (503) 344-4378
- **Mailing address fax:** (503) 305-6782

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 3663 | OR | Yes |
| 111N00000X | Chiropractor | 4107 | OR | — |

## Other

- **Enumeration date:** 07/01/2011
- **Last updated:** 06/02/2015