| LCA CASE NUMBER | I-200-19114-795274 |
| STATUS | CERTIFIED |
| LCA CASE SUBMIT | 2019-05-02 |
| DECISION DATE | 2019-05-09 |
| VISA CLASS | H-1B |
| LCA CASE EMPLOYMENT START DATE | 2019-06-13 |
| EMPLOYMENT END DATE | 2022-06-12 |
| LCA CASE EMPLOYER NAME | PROVIDENCE HEALTH & SERVICES - WASHINGTON |
| EMPLOYER BUSINESS DBA | PROVIDENCE PHYSICIAN SERVICES |
| EMPLOYER ADDRESS | 1801 LIND AVE SW |
| EMPLOYER CITY | RENTON |
| EMPLOYER STATE | WA |
| EMPLOYER POSTAL CODE | 98057 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 4255253954 |
| SECONDARY ENTITY | False |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY NAME | BETSYVO |
| AGENT ATTORNEY CITY | RENTON |
| AGENT ATTORNEY STATE | WA |
| LCA CASE JOB TITLE | RESIDENT PHYSICIAN FAMILY MEDICINE |
| SOC CODE | 29-1069 |
| SOC NAME | PHYSICIANS AND SURGEONS, ALL OTHER |
| NAICS CODE | 622110 |
| TOTAL WORKERS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| FULL TIME POSITION | True |
| PREVAILING WAGE | 56663 |
| PW UNIT OF PAY | Year |
| PW SOURCE | SURVEY |
| PW SOURCE OTHER | AAMC SURVEY OF RESIDENT/FELLOW STIPENDS AND BENEFI |
| LCA CASE WAGE RATE FROM | 56663 |
| LCA CASE WAGE RATE TO | 58200 |
| LCA CASE WAGE RATE UNIT | Year |
| H1B DEPENDENT | False |
| LCA CASE WORKLOC1 CITY | Chehalis |
| WORKSITE COUNTY | Lewis |
| LCA CASE WORKLOC1 STATE | WA |
| WORKSITE POSTAL CODE | 98532 |
| WILLFUL VIOLATOR | False |
