| LCA CASE NUMBER | I-200-21306-680692 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-11-01 |
| DECISION DATE | 2021-11-08 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Internal Medicine/Hospitalist |
| SOC CODE | 29-1063.00 |
| SOC TITLE | Internists, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2022-05-01 |
| END DATE | 2025-04-30 |
| 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 | North Bend Medical Center, Inc. |
| EMPLOYER ADDRESS1 | 1900 Woodland Drive |
| EMPLOYER CITY | Coos Bay |
| EMPLOYER STATE | OR |
| EMPLOYER POSTAL CODE | 97420 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 15412675151 |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | Walters |
| EMPLOYER POC FIRST NAME | Kelly |
| EMPLOYER POC JOB TITLE | Executive Secretary/Credentialing Coordinator |
| EMPLOYER POC ADDRESS1 | 1900 Woodland Drive |
| EMPLOYER POC CITY | Coos Bay |
| EMPLOYER POC STATE | OR |
| EMPLOYER POC POSTAL CODE | 97420 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 15412675151 |
| EMPLOYER POC EMAIL | kelly.walters@nbmconline.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Church |
| AGENT ATTORNEY FIRST NAME | Mary |
| AGENT ATTORNEY MIDDLE NAME | Kathleen |
| AGENT ATTORNEY ADDRESS1 | 755 West Big Beaver Road |
| AGENT ATTORNEY ADDRESS2 | Suite 1100 |
| AGENT ATTORNEY CITY | Troy |
| AGENT ATTORNEY STATE | MI |
| AGENT ATTORNEY POSTAL CODE | 48084 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12485199900 |
| AGENT ATTORNEY EMAIL ADDRESS | marykate.church@ellisporter.com |
| LAWFIRM NAME BUSINESS NAME | Ellis Porter PLC |
| STATE OF HIGHEST COURT | MI |
|
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | True |
| SECONDARY ENTITY BUSINESS NAME | Bay Area Hospital |
| WORKSITE ADDRESS1 | 1775 Thompson Road |
| LCA CASE WORKLOC1 CITY | Coos Bay |
| WORKSITE COUNTY | COOS |
| LCA CASE WORKLOC1 STATE | OR |
| WORKSITE POSTAL CODE | 97420 |
| LCA CASE WAGE RATE FROM | 270000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 176030 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
