Healthcare Provider Details

I. General information

NPI: 1295525665
Provider Name (Legal Business Name): RIPPLE LEARNING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 09/06/2025
Certification Date: 09/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4124 QUEBEC AVE N STE 105C
NEW HOPE MN
55427-1200
US

IV. Provider business mailing address

4550 SW BETTS AVE # 44
BEAVERTON OR
97005-2869
US

V. Phone/Fax

Practice location:
  • Phone: 425-773-8313
  • Fax:
Mailing address:
  • Phone: 425-773-8313
  • Fax: 612-500-4952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HIWOT BEKELE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 503-348-2890