| LCA CASE NUMBER | I-200-17067-514529 |
| STATUS | CERTIFIED |
| LCA CASE SUBMIT | 3/9/2017 |
| DECISION DATE | 3/16/2017 |
| VISA CLASS | H-1B |
| LCA CASE EMPLOYMENT START DATE | 9/8/2017 |
| EMPLOYMENT END DATE | 9/7/2020 |
| LCA CASE EMPLOYER NAME | PROVIDENCE HEALTH & SERVICES-WASHINGTON |
| EMPLOYER BUSINESS DBA | PROVIDENCE MEDICAL GROUP-SOUTHWEST WASHINGTON |
| EMPLOYER ADDRESS | 1801 LIND AVE SW |
| EMPLOYER CITY | RENTON |
| EMPLOYER STATE | WA |
| EMPLOYER POSTAL CODE | 98057 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | N/A |
| EMPLOYER PHONE | 4255253954 |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY NAME | RAILTON, WILLIAM |
| AGENT ATTORNEY CITY | BELLINGHAM |
| AGENT ATTORNEY STATE | WA |
| LCA CASE JOB TITLE | HOSPITALIST PHYSICIAN |
| SOC CODE | 29-1069 |
| SOC NAME | PHYSICIANS AND SURGEONS, ALL OTHER |
| NAICS CODE | 622110 |
| TOTAL WORKERS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| FULL TIME POSITION | Y |
| PREVAILING WAGE | 187,200.00 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | N/A |
| PW SOURCE | OES |
| PW SOURCE YEAR | 2016 |
| PW SOURCE OTHER | OFLC ONLINE DATA CENTER |
| LCA CASE WAGE RATE FROM | 255,000.00 |
| LCA CASE WAGE RATE TO | 0.00 |
| LCA CASE WAGE RATE UNIT | Year |
| H1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| SUPPORT H1B | NA |
| LCA CASE WORKLOC1 CITY | CENTRALIA |
| WORKSITE COUNTY | LEWIS |
| LCA CASE WORKLOC1 STATE | WA |
| WORKSITE POSTAL CODE | 98531 |
