=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053294306
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THOELKE CHIROPRACTIC & WELLNESS PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/25/2025
-----------------------------------------------------
Last Update Date | 07/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8033 W GRANDRIDGE BLVD STE C
-----------------------------------------------------
City | KENNEWICK
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99336-7159
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-783-2225
-----------------------------------------------------
Fax | 509-783-1898
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8033 W GRANDRIDGE BLVD STE C
-----------------------------------------------------
City | KENNEWICK
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99336-7159
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-783-2225
-----------------------------------------------------
Fax | 509-783-1898
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SOLE MEMBER
-----------------------------------------------------
Name | ROSS MICHAEL THOELKE
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 509-551-8216
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------