| LCA CASE NUMBER | I-200-20062-365679 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-03-02 |
| DECISION DATE | 2020-03-09 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Physician Internal Medicine |
| SOC CODE | 29-1063.00 |
| SOC TITLE | Internists, General |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2020-06-20 |
| END DATE | 2023-06-19 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Providence Health & Services - Washington |
| TRADE NAME DBA | Physician Management Group |
| EMPLOYER ADDRESS1 | 1801 Lind Ave SW, Pariseau Building |
| EMPLOYER ADDRESS2 | 2nd Floor |
| EMPLOYER CITY | Renton |
| EMPLOYER STATE | WA |
| EMPLOYER POSTAL CODE | 98057 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 14255253954 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | JEANES |
| EMPLOYER POC FIRST NAME | MARIA |
| EMPLOYER POC MIDDLE NAME | S |
| EMPLOYER POC JOB TITLE | Immigration Program Manager |
| EMPLOYER POC ADDRESS1 | 1801 Lind Ave SW, Pariseau Building |
| EMPLOYER POC ADDRESS2 | 2nd Floor |
| EMPLOYER POC CITY | Renton |
| EMPLOYER POC STATE | WA |
| EMPLOYER POC POSTAL CODE | 98057 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 14255253954 |
| EMPLOYER POC EMAIL | maria.jeanes@providence.org |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Vo |
| AGENT ATTORNEY FIRST NAME | Betsy |
| AGENT ATTORNEY MIDDLE NAME | M. |
| AGENT ATTORNEY ADDRESS1 | 1801 Lind Ave SW, Pariseau Building |
| AGENT ATTORNEY ADDRESS2 | 2nd Floor |
| AGENT ATTORNEY CITY | Renton |
| AGENT ATTORNEY STATE | WA |
| AGENT ATTORNEY POSTAL CODE | 98057 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 14255253940.0 |
| AGENT ATTORNEY EMAIL ADDRESS | betsy.vo@providence.org |
| LAWFIRM NAME BUSINESS NAME | Providence Health & Services |
| STATE OF HIGHEST COURT | WA |
| NAME OF HIGHEST STATE COURT | Washington State Supreme Court |
| WORKSITE WORKERS | 1.0 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 820 S McClellan Street |
| WORKSITE ADDRESS2 | Suite 500 |
| LCA CASE WORKLOC1 CITY | Spokane |
| WORKSITE COUNTY | SPOKANE |
| LCA CASE WORKLOC1 STATE | WA |
| WORKSITE POSTAL CODE | 99204 |
| LCA CASE WAGE RATE FROM | 100.0 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 100.0 |
| PW UNIT OF PAY | Hour |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 1.0 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Vo |
| PREPARER FIRST NAME | Betsy |
| PREPARER MIDDLE INITIAL | M. |
| PREPARER BUSINESS NAME | Providence Health & Services |
| PREPARER EMAIL | betsy.vo@providence.org |
