| LCA CASE NUMBER | I-200-20265-835797 |
| STATUS | Certified - Withdrawn |
| LCA CASE SUBMIT | 2020-09-21 |
| DECISION DATE | 2023-09-08 |
| ORIGINAL CERT DATE | 2020-09-28 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Physician |
| SOC CODE | 29-1062.00 |
| SOC TITLE | Family and General Practitioners |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2020-12-14 |
| END DATE | 2023-12-13 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Umpqua Community Health Center Inc. |
| TRADE NAME DBA | Aviva Health |
| EMPLOYER ADDRESS1 | 150 NE Kenneth Ford Dr |
| EMPLOYER CITY | Roseburg |
| EMPLOYER STATE | OR |
| EMPLOYER POSTAL CODE | 97470 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 15416729596 |
| NAICS CODE | 6211 |
| EMPLOYER POC LAST NAME | Normand |
| EMPLOYER POC FIRST NAME | Guy |
| EMPLOYER POC JOB TITLE | Director of Human Resources |
| EMPLOYER POC ADDRESS1 | 150 NE Kenneth Ford Dr |
| EMPLOYER POC CITY | Roseburg |
| EMPLOYER POC STATE | OR |
| EMPLOYER POC POSTAL CODE | 97470 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 15416729596 |
| EMPLOYER POC EMAIL | gnormand@umpquachc.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Salter |
| AGENT ATTORNEY FIRST NAME | Michelle |
| AGENT ATTORNEY MIDDLE NAME | Luzentales |
| AGENT ATTORNEY ADDRESS1 | 920 Fifth Avenue |
| AGENT ATTORNEY ADDRESS2 | Suite 3300 |
| AGENT ATTORNEY CITY | Seattle |
| AGENT ATTORNEY STATE | WA |
| AGENT ATTORNEY POSTAL CODE | 98104 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12067578342 |
| AGENT ATTORNEY EMAIL ADDRESS | michellesalter@dwt.com |
| LAWFIRM NAME BUSINESS NAME | Davis Wright Tremaine LLP |
| STATE OF HIGHEST COURT | WA |
| NAME OF HIGHEST STATE COURT | Washington Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 790 S. Main Street |
| LCA CASE WORKLOC1 CITY | Myrtle Creek |
| WORKSITE COUNTY | DOUGLAS |
| LCA CASE WORKLOC1 STATE | OR |
| WORKSITE POSTAL CODE | 97457 |
| LCA CASE WAGE RATE FROM | 247253 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 208000 |
| PW UNIT OF PAY | Year |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H 1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
