Organization
ORIGIN HEALTH & LONGEVITY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL KENT BUTTARS NP (OWNER)
(208) 283-4929
Entity
Organization
Contact information
Practice address
4686 N ALAMEDA CREEK AVE, MERIDIAN, ID 83646-2017
(208) 283-4929
Mailing address
4686 N ALAMEDA CREEK AVE, MERIDIAN, ID 83646-2017
(208) 283-4929
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/23/2026
Last updated
05/23/2026
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