Individual
MATTELYNN ELLISE MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6200 SW ARCTIC DR, BEAVERTON, OR 97005-9447
(458) 219-5557
Mailing address
410 NE DEKUM ST APT 401, PORTLAND, OR 97211-2982
(458) 219-5557
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/22/2026
Last updated
05/22/2026
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