Individual ProviderAnthony MckinleyCounselorBehavioral Health & Social Service ProvidersPractice Address10714 NE Glisan St, Portland, OR 97220-4046(503) 645-3581(503) 260-3664PECOS EnrollmentBased on the most recent information from CMS, provider Anthony Mckinley does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1467075960Provider TypeIndividualFull NameMckinley, AnthonyGenderMaleSole ProprietorYesEnumeration Date5/19/2020Last Updated5/19/2020Contact InformationPractice LocationPractice Address10714 NE Glisan St, Portland, OR 97220-4046Phone(503) 645-3581FaxUnlisted FaxMailing LocationMailing Address1052 SW Wallula Dr, Gresham, OR 97080-9671Phone(503) 260-3664FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer