Individual
KATHERINE NICOLE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8700 SW CREEKSIDE PL, BEAVERTON, OR 97008-7391
(503) 224-2184
Mailing address
8700 SW CREEKSIDE PL, BEAVERTON, OR 97008-7391
(503) 224-2184
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/25/2022
Last updated
04/25/2022
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