This is a very delightful, folky image of the elk head with both eyes facing forward on a three quarter profile of the head. Very Picasso! Very Modern!  All of the beads are tiny sparkling cut beads indicating it was made in Eastern Washington, the Pendleton area in Oregon or possibly Nez Perce. The pouch is made with thick commercial leather with rolled beading covering the edges of the flap and the edges of both panels of the pocket. The belt pouch is in excellent condition. It is an excellent example of Plateau beadwork 

L.4 ¾" : W. 4 ⅛"