| LCA CASE NUMBER | I-200-21160-383927 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-06-09 |
| DECISION DATE | 2021-06-16 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | DENTIST |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-10-01 |
| END DATE | 2024-09-30 |
| 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 | NICHOLAS DELISLE DDS P.L.L.C. |
| TRADE NAME DBA | HARBOR KIDS DENTAL |
| EMPLOYER ADDRESS1 | 216 W. HERON ST. |
| EMPLOYER CITY | ABERDEEN |
| EMPLOYER STATE | WA |
| EMPLOYER POSTAL CODE | 98520 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 13605325437 |
| NAICS CODE | 6212 |
| EMPLOYER POC LAST NAME | REAMS |
| EMPLOYER POC FIRST NAME | SUSANNE |
| EMPLOYER POC JOB TITLE | DIRECTOR OF HR AND COMPLIANCE |
| EMPLOYER POC ADDRESS 1 | 4643 S. ULSTER ST. |
| EMPLOYER POC ADDRESS 2 | SUITE 300 |
| EMPLOYER POC CITY | DENVER |
| EMPLOYER POC STATE | CO |
| EMPLOYER POC POSTAL CODE | 80237 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 17206034787 |
| EMPLOYER POC EMAIL | SREAMS@LONEPEAKDENTALGROUP.COM |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | ANGEL |
| AGENT ATTORNEY FIRST NAME | ANNA |
| AGENT ATTORNEY MIDDLE NAME | FRANCIS |
| AGENT ATTORNEY ADDRESS1 | 2000 S. COLORADO BLVD; TWR 3 |
| AGENT ATTORNEY ADDRESS2 | SUTIE 900 |
| AGENT ATTORNEY CITY | DENVER |
| AGENT ATTORNEY STATE | CO |
| AGENT ATTORNEY POSTAL CODE | 80222 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 13037646800 |
| AGENT ATTORNEY EMAIL ADDRESS | ANNA.ANGEL@OGLETREEDEAKINS.COM |
| LAWFIRM NAME BUSINESS NAME | OGLETREE DEAKINS |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | NYS THIRD DISTRICT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 216 W. Heron St. |
| LCA CASE WORKLOC1 CITY | Aberdeen |
| WORKSITE COUNTY | GRAYS HARBOR |
| LCA CASE WORKLOC1 STATE | WA |
| WORKSITE POSTAL CODE | 98520 |
| LCA CASE WAGE RATE FROM | 250000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 177507 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Gigliotti |
| PREPARER FIRST NAME | Mary |
| PREPARER MIDDLE INITIAL | E |
| PREPARER BUSINESS NAME | Ogletree Deakins |
| PREPARER EMAIL | Mary.gigliotti@odnss.com |
