Provider Demographics
NPI:1669685723
Name:HOITINK, TONI C (OD)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:C
Last Name:HOITINK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3822 W 47TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99337-2787
Mailing Address - Country:US
Mailing Address - Phone:509-585-8798
Mailing Address - Fax:
Practice Address - Street 1:2720 S QUILLAN ST
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99337-2404
Practice Address - Country:US
Practice Address - Phone:509-585-8314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3085TX152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UO 9725Medicare UPIN