| LCA CASE NUMBER | I-200-21154-366713 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-06-03 |
| DECISION DATE | 2021-06-10 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Clinician Teaching Fellow |
| SOC CODE | 29-1069.00 |
| SOC TITLE | Physicians and Surgeons, All Other |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-07-04 |
| END DATE | 2022-07-31 |
| 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 | Providence Health & Services - Washington |
| 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 | 14256156359 |
| 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 ADDRESS 1 | 1801 Lind Ave SW, Pariseau Building |
| EMPLOYER POC ADDRESS 2 | 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 | 14256156359 |
| EMPLOYER POC EMAIL | maria.jeanes@providence.org |
| AGENT REPRESENTING EMPLOYER | True |
| 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 | 14259439907 |
| 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 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 101 W. 8th Avenue |
| LCA CASE WORKLOC1 CITY | Spokane |
| WORKSITE COUNTY | SPOKANE |
| LCA CASE WORKLOC1 STATE | WA |
| WORKSITE POSTAL CODE | 99204 |
| LCA CASE WAGE RATE FROM | 71242 |
| LCA CASE WAGE RATE TO | 82000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 71242 |
| PW UNIT OF PAY | Year |
| PW OTHER SOURCE | Survey |
| PW OTHER YEAR | 2020 |
| PW SURVEY PUBLISHER | AAMC Survey of Resident/Fellow Stipends and Benefits |
| PW SURVEY NAME | AAMC Survey of Resident/Fellow Stipends and Benefits |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| 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 |
