Provider Demographics
NPI:1457248346
Name:SPRUCE COVE ACUPUNCTURE LLC
Entity type:Organization
Organization Name:SPRUCE COVE ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:GATES
Authorized Official - Suffix:
Authorized Official - Credentials:MSOM
Authorized Official - Phone:971-235-6800
Mailing Address - Street 1:1500 RUSSIAN JACK DR APT 11
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-6028
Mailing Address - Country:US
Mailing Address - Phone:971-235-0680
Mailing Address - Fax:
Practice Address - Street 1:1500 RUSSIAN JACK DR APT 11
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-6028
Practice Address - Country:US
Practice Address - Phone:971-235-0680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty