\ H1B CASE NUMBER I-200-20155-625171



CASE NUNBER: I-200-20155-625171

LCA CASE NUMBERI-200-20155-625171
STATUSCertified - Withdrawn
LCA CASE SUBMIT2020-06-03
DECISION DATE2021-02-04
ORIGINAL CERT DATE2020-06-10
VISA CLASSH-1B
LCA CASE JOB TITLEData Engineer II
SOC CODE15-1133.00
SOC TITLESoftware Developers, Systems Software
FULL TIME POSITIONTrue
LCA CASE EMPLOYMENT START DATE2020-06-10
END DATE2023-06-09
TOTAL WORKER POSITIONS1
NEW EMPLOYMENT0
CONTINUED EMPLOYMENT0
CHANGE PREVIOUS EMPLOYMENT0
NEW CONCURRENT EMPLOYMENT0
CHANGE EMPLOYER1
AMENDED PETITION0
LCA CASE EMPLOYER NAMEPREMERA BLUE CROSS
EMPLOYER ADDRESS17001 220TH STREET SW
EMPLOYER CITYMOUNTLAKE TERRACE
EMPLOYER STATEWA
EMPLOYER POSTAL CODE98043
EMPLOYER COUNTRYUNITED STATES OF AMERICA
EMPLOYER PHONE14259184000
NAICS CODE52411
EMPLOYER POC LAST NAMEBROOKMAN
EMPLOYER POC FIRST NAMEJANELLE
EMPLOYER POC JOB TITLEHR COMPLIANCE CONSULTANT
EMPLOYER POC ADDRESS 17001 220TH STREET SW
EMPLOYER POC CITYMOUNTLAKE TERRACE
EMPLOYER POC STATEWA
EMPLOYER POC POSTAL CODE98043
EMPLOYER POC COUNTRYUNITED STATES OF AMERICA
EMPLOYER POC PHONE14259183363
EMPLOYER POC EMAILJANELLE.BROOKMAN@PREMERA.COM
AGENT REPRESENTING EMPLOYERTrue
AGENT ATTORNEY LAST NAMEKye
AGENT ATTORNEY FIRST NAMEEdwina
AGENT ATTORNEY MIDDLE NAMEC.
AGENT ATTORNEY ADDRESS11201 Third Avenue
AGENT ATTORNEY ADDRESS2Suite 2750
AGENT ATTORNEY CITYSeattle
AGENT ATTORNEY STATEWA
AGENT ATTORNEY POSTAL CODE98101
AGENT ATTORNEY COUNTRYUNITED STATES OF AMERICA
AGENT ATTORNEY PHONE12066822308
AGENT ATTORNEY EMAIL ADDRESSsea-immigration@fisherphillips.com
LAWFIRM NAME BUSINESS NAMEFisher & Phillips LLP
STATE OF HIGHEST COURTNY
NAME OF HIGHEST STATE COURTCourt of Appeals
WORKSITE WORKERS1
SECONDARY ENTITYFalse
WORKSITE ADDRESS17001 220th Street SW
LCA CASE WORKLOC1 CITYMountlake Terrace
WORKSITE COUNTYSNOHOMISH
LCA CASE WORKLOC1 STATEWA
WORKSITE POSTAL CODE98043
LCA CASE WAGE RATE FROM107000
LCA CASE WAGE RATE UNITYear
PREVAILING WAGE101546
PW UNIT OF PAYYear
PW WAGE LEVELII
PW OES YEAR7/1/2019 - 6/30/2020
TOTAL WORKSITE LOCATIONS1
AGREE TO LC STATEMENTTrue
H1B DEPENDENTFalse
WILLFUL VIOLATORFalse
PUBLIC DISCLOSUREDisclose Employment
PREPARER LAST NAMEOem
PREPARER FIRST NAMEClara
PREPARER BUSINESS NAMEFisher & Phillips LLP
PREPARER EMAILsea-immigration@fisherphillips.com