Healthcare Provider Details

I. General information

NPI: 1053294306
Provider Name (Legal Business Name): THOELKE CHIROPRACTIC & WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8033 W GRANDRIDGE BLVD STE C
KENNEWICK WA
99336-7159
US

IV. Provider business mailing address

8033 W GRANDRIDGE BLVD STE C
KENNEWICK WA
99336-7159
US

V. Phone/Fax

Practice location:
  • Phone: 509-783-2225
  • Fax: 509-783-1898
Mailing address:
  • Phone: 509-783-2225
  • Fax: 509-783-1898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: ROSS MICHAEL THOELKE
Title or Position: SOLE MEMBER
Credential: DC
Phone: 509-551-8216