# FORGED WELLNESS & CO

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730013897
- **Authorized official:** KATHLEEN RACICOT PA-C (CO-OWNER)
- **Authorized official phone:** (503) 347-1805

## Contact information

- **Practice address:** 3300 RASER DR, MISSOULA, MT 59808-1534
- **Practice address phone:** (406) 213-6484
- **Mailing address:** 3300 RASER DR, MISSOULA, MT 59808-1534
- **Mailing address phone:** (406) 213-6484

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | NULL | Yes |
| 363A00000X | Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 06/11/2026
- **Last updated:** 07/26/2026