I figured out what went wrong and it's working now.
My install was based on the instructions on VXDIAG. A few things that I've changed from previous install:
1. Plugged in the dongle before running VX manager. Make sure you see the dongle in the VX manager app.
2. Do NOT open Techstream using the the real Techstream icon that was created on your desktop. You have to go to the BIN folder and use the Toyota Launcher application, it will automatically bring up Techstream. By doing it this way, Techstream no longer ask for the Key. I created a shortcut to put on my desktop so I will not need to dig through the folders to find the Toyota Launcher next time.
3. After Techstream is loaded, go to Setup>VIM Select> open the dropdown and choose TOYOTA-J2534. This is something that's not listed in the instruction but it's super important because the default is TIS Techstream VIM. If you don't choose TOYTO-J2543, your dongle will not talk to your Techstream.
4. I have a press button start car. Press the start button on the car twice. Connect your car to the dongle. Click connect to vehicle in Techstream and you should see your car's information automatically populated.
Good luck!