| LCA CASE NUMBER | I-200-21217-505914 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-08-05 |
| DECISION DATE | 2021-08-12 |
| 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 | 2021-11-01 |
| END DATE | 2024-10-31 |
| 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 | Community Health Association of Spokane |
| EMPLOYER ADDRESS1 | 611 N Iron Bridge Way |
| EMPLOYER CITY | Spokane |
| EMPLOYER STATE | WA |
| EMPLOYER POSTAL CODE | 99202 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 15094448888 |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Halvorson |
| EMPLOYER POC FIRST NAME | Nathan |
| EMPLOYER POC JOB TITLE | Compliance Officer |
| EMPLOYER POC ADDRESS1 | 611 N Iron Bridge Way |
| EMPLOYER POC CITY | Spokane |
| EMPLOYER POC STATE | WA |
| EMPLOYER POC POSTAL CODE | 99202 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 15094448888 |
| EMPLOYER POC EMAIL | nhalvorson@chas.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Roach |
| AGENT ATTORNEY FIRST NAME | Eamonn |
| AGENT ATTORNEY MIDDLE NAME | Patrick Sullivan |
| AGENT ATTORNEY ADDRESS1 | 9221 Sandifur Parkway |
| AGENT ATTORNEY ADDRESS2 | Suite C |
| AGENT ATTORNEY CITY | Pasco |
| AGENT ATTORNEY STATE | WA |
| AGENT ATTORNEY POSTAL CODE | 99301 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 15095477587 |
| AGENT ATTORNEY EMAIL ADDRESS | eroach@roachlaw.com |
| LAWFIRM NAME BUSINESS NAME | ROACH & BISHOP, LLP |
| STATE OF HIGHEST COURT | WA |
| NAME OF HIGHEST STATE COURT | Washington State Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 803 S Main Street |
| WORKSITE ADDRESS2 | Suite 120 |
| LCA CASE WORKLOC1 CITY | Moscow |
| WORKSITE COUNTY | LATAH |
| LCA CASE WORKLOC1 STATE | ID |
| WORKSITE POSTAL CODE | 83843 |
| LCA CASE WAGE RATE FROM | 172105 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 116438 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | True |
| H-1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Todd |
| PREPARER FIRST NAME | Rachel |
| PREPARER MIDDLE INITIAL | B |
| PREPARER BUSINESS NAME | ROACH & BISHOP, LLP |
| PREPARER EMAIL | rtodd@roachlaw.com |
