| LCA CASE NUMBER | I-200-20141-590298 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-05-20 |
| DECISION DATE | 2020-05-28 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Family Medicine Physician |
| SOC CODE | 29-1062.00 |
| SOC TITLE | Family and General Practitioners |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2020-07-01 |
| END DATE | 2023-06-30 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Tri-State Memorial Hospital |
| EMPLOYER ADDRESS1 | 1221 Highland Avenue |
| EMPLOYER CITY | Clarkston |
| EMPLOYER STATE | WA |
| EMPLOYER POSTAL CODE | 99403 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 15097585511 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Carper |
| EMPLOYER POC FIRST NAME | Joleen |
| EMPLOYER POC MIDDLE NAME | L |
| EMPLOYER POC JOB TITLE | Chief of Clinic Operations |
| EMPLOYER POC ADDRESS1 | 1221 Highland Avenue |
| EMPLOYER POC CITY | Clarkston |
| EMPLOYER POC STATE | WA |
| EMPLOYER POC POSTAL CODE | 99403 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 15097585511 |
| EMPLOYER POC EMAIL | jcarper@tsmh.org |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Roach |
| AGENT ATTORNEY FIRST NAME | Eamonn |
| AGENT ATTORNEY MIDDLE NAME | Patrick Sullivan |
| AGENT ATTORNEY ADDRESS1 | 9221 Sandifur Parkway |
| AGENT ATTORNEY ADDRESS2 | Suite C |
| AGENT ATTORNEY CITY | Pasco |
| AGENT ATTORNEY STATE | WA |
| AGENT ATTORNEY POSTAL CODE | 99301 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 15095477587.0 |
| AGENT ATTORNEY EMAIL ADDRESS | eroach@roachlaw.com |
| LAWFIRM NAME BUSINESS NAME | Roach & Bishop, LLP |
| STATE OF HIGHEST COURT | WA |
| NAME OF HIGHEST STATE COURT | WA State Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 1119 Highland Avenue |
| LCA CASE WORKLOC1 CITY | Clarkston |
| WORKSITE COUNTY | ASOTIN |
| LCA CASE WORKLOC1 STATE | WA |
| WORKSITE POSTAL CODE | 99403 |
| LCA CASE WAGE RATE FROM | 236935.0 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 114566.0 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Miller |
| PREPARER FIRST NAME | Maria |
| PREPARER MIDDLE INITIAL | G |
| PREPARER BUSINESS NAME | Roach & Bishop, LLP |
| PREPARER EMAIL | gmiller@roachlaw.com |
