Provider Demographics
NPI:1083697189
Name:TOFTNESS, KIMBERLY RAE (DC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:RAE
Last Name:TOFTNESS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 N MISSION ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2065
Mailing Address - Country:US
Mailing Address - Phone:509-662-4711
Mailing Address - Fax:509-662-2800
Practice Address - Street 1:610 N MISSION ST
Practice Address - Street 2:SUITE 102
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2065
Practice Address - Country:US
Practice Address - Phone:509-662-4711
Practice Address - Fax:509-662-2800
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00033766111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU77535Medicare UPIN
WA8854530Medicare ID - Type Unspecified