Healthcare Provider Details

I. General information

NPI: 1851216394
Provider Name (Legal Business Name): IRONCLAD HUMAN PERFORMANCE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1714 EDGEMOOR LN
EVERETT WA
98203-1663
US

IV. Provider business mailing address

1714 EDGEMOOR LN
EVERETT WA
98203-1663
US

V. Phone/Fax

Practice location:
  • Phone: 360-347-6504
  • Fax:
Mailing address:
  • Phone: 360-347-6504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. CAROLYN L VAN DER MEULEN
Title or Position: OWNER
Credential: OTD, OTR/L
Phone: 360-347-6504